{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T15:04:48Z","timestamp":1789657488494,"version":"4.0.1"},"reference-count":19,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T00:00:00Z","timestamp":1745366400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T00:00:00Z","timestamp":1745366400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Resuscitation strategies for massive hemorrhage increasingly involve the use of low\u2010titer group O whole blood (LTOWB) due to evidence suggesting improved patient outcomes. However, the potential risk of incorrect ABO typing following LTOWB administration, possibly leading to mis\u2010transfusion, remains insufficiently explored. This case series aims to highlight the potential risk of ABO mistyping associated with LTOWB transfusions in trauma settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design and Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed three cases involving trauma patients who received LTOWB transfusions at a high\u2010volume urban Level 1 Trauma Center. ABO and RhD typing were performed using automated column agglutination technology (Ortho ID\u2010MTS\u2122), and discordant typing results prompted further investigations to confirm patients' true ABO type and identify mis\u2010transfusions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All three patients initially received LTOWB due to traumatic hemorrhage. Initial ABO typing after LTOWB administration incorrectly identified the patients as group O. Follow\u2010up investigations later confirmed their true blood types as group A. Two cases resulted in subsequent inadvertent transfusions of ABO\u2010incompatible plasma. Although no severe adverse clinical outcomes occurred, these events were reported to regulatory bodies as biologic product deviations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Our findings highlight a rare but clinically significant risk of ABO typing errors following LTOWB transfusion, primarily due to contamination of patient samples with donor blood. Such errors carry the potential for acute hemolytic reactions, underscoring the critical need for strict adherence to sampling protocols. Whenever possible, ABO typing should be performed prior to LTOWB administration, and samples should be drawn from a site contralateral to the transfusion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.18268","type":"journal-article","created":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T02:25:28Z","timestamp":1745461528000},"page":"1203-1209","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Incorrect blood typing and mis\u2010transfusion due to low\u2010titer group O whole blood resuscitation"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5006-7068","authenticated-orcid":false,"given":"Miriam","family":"Brown","sequence":"first","affiliation":[{"name":"Department of Pathology, Microbiology, and Immunology Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deva","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Pathology, Microbiology, and Immunology Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaycie","family":"Atchison","sequence":"additional","affiliation":[{"name":"Quality, Safety, &amp; Risk Prevention Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2419-2102","authenticated-orcid":false,"given":"Bradley M.","family":"Dennis","sequence":"additional","affiliation":[{"name":"Division of Acute Care Surgery, Department of Surgery, Section of Surgical Sciences Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Hall","sequence":"additional","affiliation":[{"name":"Department of Pathology, Microbiology, and Immunology Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Mueller","sequence":"additional","affiliation":[{"name":"Department of Pathology, Microbiology, and Immunology Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Schaeffer","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica E.","family":"Schucht","sequence":"additional","affiliation":[{"name":"Division of Acute Care Surgery, Department of Surgery, Section of Surgical Sciences Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill R.","family":"Streams","sequence":"additional","affiliation":[{"name":"Division of Acute Care Surgery, Department of Surgery, Section of Surgical Sciences Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toufik","family":"Tahiri","sequence":"additional","affiliation":[{"name":"Department of Pathology, Microbiology, and Immunology Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8422-9480","authenticated-orcid":false,"given":"Garrett S.","family":"Booth","sequence":"additional","affiliation":[{"name":"Department of Pathology, Microbiology, and Immunology Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5719-9685","authenticated-orcid":false,"given":"Jeremy W.","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Department of Pathology, Microbiology, and Immunology Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,23]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.17746"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/voxs.12495"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.16394"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31817e2ef9"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.15086"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/ccm.0000000000006244"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtha.2023.09.025"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.15696"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2012.03576.x"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2018-10-833988"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.16121"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.19848"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.19904"},{"key":"e_1_2_6_15_1","volume-title":"Standards for blood banks and transfusion services","year":"2024"},{"key":"e_1_2_6_16_1","unstructured":"US Food & Drug Administration.Biological product deviation reporting for blood and plasma establishments. 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