{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T06:03:11Z","timestamp":1763186591980,"version":"3.45.0"},"reference-count":17,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T00:00:00Z","timestamp":1758067200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["DP5OD033357"],"award-info":[{"award-number":["DP5OD033357"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Immune hemolytic anemia poses a significant challenge in transfusion medicine, as identification of underlying alloantibodies can be masked by warm and\/or cold autoantibodies. This increases the risk of transfusing incompatible blood, which can precipitate or exacerbate hemolysis. Identifying alloantibodies in the presence of autoantibodies remains difficult with standard serologic and genotypic methods, often delaying accurate diagnosis and appropriate transfusion strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Report<\/jats:title>\n                    <jats:p>\n                      We describe a 63\u2010year\u2010old woman with autoimmune hemolytic anemia who suffered near\u2010fatal hemolysis following transfusion. Despite extensive serologic and genotypic testing, the cause of her hemolytic transfusion reactions remained elusive. Given her clinical course and transfusion history, we hypothesized that her acute hemolytic transfusion reactions could be due to immune sensitization to a high\u2010incidence RBC antigen. Research whole\u2010genome long\u2010read sequencing (LRS) revealed homozygosity for a rare\n                      <jats:italic>KEL*02N.16<\/jats:italic>\n                      allele, consistent with a rare Ko phenotype, which was validated by Sanger sequencing. Retrospective serologic testing with Ko RBCs further confirmed alloimmunization within the Kell system.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case highlights the limitations of conventional serologic and genotypic methods in detecting rare blood group phenotypes, and emphasizes the diagnostic power of long\u2010read sequencing in transfusion medicine. Early molecular testing in complex hemolytic cases can facilitate targeted transfusion strategies, reduce the risk of severe hemolysis, and improve patient outcomes. As sequencing technologies become more accessible, they have the potential to revolutionize blood group typing and alloimmunization risk assessment in clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.18403","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T09:14:06Z","timestamp":1758100446000},"page":"2192-2198","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010read\n                    <scp>DNA<\/scp>\n                    sequencing resolves a rare case of alloimmune hemolysis mimicking autoimmune hemolysis"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7821-6571","authenticated-orcid":false,"given":"Hui Xiao","family":"Chao","sequence":"first","affiliation":[{"name":"Department of Hematology\/Oncology Clinical Research Division, University of Washington, Fred Hutch Cancer Center  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, Division of Transfusion Medicine University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Livia","family":"Hegerova","sequence":"additional","affiliation":[{"name":"Department of Hematology\/Oncology Clinical Research Division, University of Washington, Fred Hutch Cancer Center  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theresa","family":"Nester","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, Division of Transfusion Medicine University of Washington  Seattle Washington USA"},{"name":"Bloodworks Northwest, Immunohematology Reference and Red cell Genomics Laboratories  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina","family":"Sen","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, Division of Transfusion Medicine University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"LaySee","family":"Er","sequence":"additional","affiliation":[{"name":"Bloodworks Northwest, Immunohematology Reference and Red cell Genomics Laboratories  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha","family":"Harris","sequence":"additional","affiliation":[{"name":"Bloodworks Northwest, Immunohematology Reference and Red cell Genomics Laboratories  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tina","family":"Lockwood","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jillian G.","family":"Buchan","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kerry W.","family":"Lannert","sequence":"additional","affiliation":[{"name":"Institute for Stem Cell and Regenerative Medicine, University of Washington  Seattle Washington USA"},{"name":"Department of Medicine University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Gasper","sequence":"additional","affiliation":[{"name":"Institute for Stem Cell and Regenerative Medicine, University of Washington  Seattle Washington USA"},{"name":"Department of Medicine University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2346-2879","authenticated-orcid":false,"given":"Joy","family":"Goffena","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Genetic Medicine University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miranda P. G.","family":"Zalusky","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Genetic Medicine University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophie H. R.","family":"Storz","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Genetic Medicine University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Celina","family":"Montemayor\u2010Garcia","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathobiology University of Toronto  Toronto Ontario Canada"},{"name":"Department of Pathology and Molecular Medicine McMaster University  Hamilton Ontario Canada"},{"name":"Medical, Laboratory and Stem Cell Services, Canadian Blood Services  Brampton Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5183-6471","authenticated-orcid":false,"given":"Monica B.","family":"Pagano","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, Division of Transfusion Medicine University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jill M.","family":"Johnsen","sequence":"additional","affiliation":[{"name":"Institute for Stem Cell and Regenerative Medicine, University of Washington  Seattle Washington USA"},{"name":"Department of Medicine University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7814-9150","authenticated-orcid":false,"given":"Sandhya R.","family":"Panch","sequence":"additional","affiliation":[{"name":"Department of Hematology\/Oncology Clinical Research Division, University of Washington, Fred Hutch Cancer Center  Seattle Washington USA"},{"name":"Department of Laboratory Medicine and Pathology, Division of Transfusion Medicine University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danny E.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology University of Washington  Seattle Washington USA"},{"name":"Department of Pediatrics, Division of Genetic Medicine University of Washington  Seattle Washington USA"},{"name":"Brotman Baty Institute for Precision Medicine University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,9,17]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"International Society of Blood Transfusion (ISBT).International Society of Blood Transfusion (ISBT).https:\/\/www.isbtweb.org\/. Accessed 26 Jan 2025."},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.7759\/CUREUS.26051"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41587-021-01108-x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/J.1537-2995.2007.01174.X"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/J.1537-2995.2007.01308.X"},{"key":"e_1_2_8_7_1","first-page":"1","volume-title":"The blood group antigen FactsBook","author":"Reid ME","year":"2003"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/TRF.17608"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1074\/JBC.M009879200"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/J.1365-3148.2009.00962.X"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.4103\/0973-6247.200782"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/VOX.12914"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1182\/BLOOD-2018-08-833962"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.GIMO.2024.101833"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41576-020-0236-x"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.AJHG.2025.01.002"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/VOX.12217"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.3324\/HAEMATOL.12074"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.18403","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T05:58:51Z","timestamp":1763186331000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/trf.18403"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,17]]},"references-count":17,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1111\/trf.18403"],"URL":"https:\/\/doi.org\/10.1111\/trf.18403","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"type":"print","value":"0041-1132"},{"type":"electronic","value":"1537-2995"}],"subject":[],"published":{"date-parts":[[2025,9,17]]},"assertion":[{"value":"2025-03-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}