{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T14:36:32Z","timestamp":1791729392551,"version":"4.3.4"},"reference-count":20,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T00:00:00Z","timestamp":1772841600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T00:00:00Z","timestamp":1772841600000},"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":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Accurate ABO determination is critical for safe deceased donor organ allocation. Weak or variant ABO subgroups may not be reliably detected by routine serologic testing, especially under urgent conditions or following transfusion. Such limitations can result in discrepant ABO assignments with potential implications for transplant safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design and Methods<\/jats:title>\n                    <jats:p>We describe a deceased organ donor with discordant ABO typing results reported by two laboratories. Serologic testing was performed using gel agglutination methods on independently collected specimens. Due to persistent discrepancies, ABO genotyping was performed using real\u2010time polymerase chain reaction to resolve the donor's blood group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Initial serologic testing identified the donor as AB RhD+ at one laboratory, while a second laboratory reported B RhD+ results. Repeat serologic evaluation demonstrated weak and variable A antigen reactivity, suggestive of a weak A subgroup. Molecular genotyping performed on specimens from both laboratories identified an AwB genotype, confirming the presence of a weak A allele. Because molecular results were not available prior to organ allocation and the discrepancy could not be resolved in real time, the donor was conservatively classified as AB for allocation purposes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This case highlights the vulnerability of routine serologic testing to misclassification of rare weak ABO subgroups. Integration of molecular genotyping with serologic testing can provide resolution of ABO discrepancies and enhance transplant safety. This case demonstrates a policy\u2010relevant gap in current ABO determination workflows for deceased donors. Lack of standardized inter\u2010laboratory data sharing and limited access to rapid molecular testing may unnecessarily restrict organ utilization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.70148","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T15:45:18Z","timestamp":1772984718000},"page":"952-956","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Deceased donor\n                    <scp>ABO<\/scp>\n                    discrepancy due to a rare\n                    <scp>AwB<\/scp>\n                    subgroup: Implications for organ allocation"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6373-7962","authenticated-orcid":false,"given":"Sara O.","family":"Dionne","sequence":"first","affiliation":[{"name":"Eurofins Donor and Product Testing  Centennial Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7410-920X","authenticated-orcid":false,"given":"Kelsey","family":"Smith","sequence":"additional","affiliation":[{"name":"Eurofins Donor and Product Testing  Winston Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6411-0097","authenticated-orcid":false,"given":"Luis","family":"Santiago","sequence":"additional","affiliation":[{"name":"Eurofins Donor and Product Testing  Centennial Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6923-2107","authenticated-orcid":false,"given":"Brenden","family":"O'Neale","sequence":"additional","affiliation":[{"name":"Eurofins Donor and Product Testing  Centennial Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,7]]},"reference":[{"issue":"7391","key":"e_1_2_9_2_1","first-page":"717","article-title":"When Jesica died","volume":"326","author":"Hopkins Tanne J","year":"2003","journal-title":"BMJ"},{"key":"e_1_2_9_3_1","unstructured":"BarclayL.ABO Incompatibility in Heart\u2010Lung Transplant: An Expert Interview With Robert A. Metzger MD.Medscape. February 21 2003. [cited 2025 Nov 29]. Available from:https:\/\/www.medscape.com\/viewarticle\/449763"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3148.2009.00950.x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.21307\/immunohematology-2019-231"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.4103\/ajts.AJTS_118_17"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.608716"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.htct.2024.04.127"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.14654"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tracli.2021.06.006"},{"key":"e_1_2_9_11_1","unstructured":"Organ Procurement and Transplantation Network (OPTN).Proposal to Modify ABO Determination Reporting and Verification Policies. OPTN Policy Notice.2015[cited 2026 Jan 13]. Available from:https:\/\/optn.transplant.hrsa.gov\/media\/1210\/policy_notice_abo_10-29-2015.pdf"},{"key":"e_1_2_9_12_1","unstructured":"Organ Procurement and Transplantation Network (OPTN).Policy 2.6: Deceased Donor Blood Type Determination and Reporting. OPTN Policies. OPTN Policy Notice.2025[cited 2026 Jan 13]. Available from:https:\/\/optn.transplant.hrsa.gov"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.2450\/2018.0091-18"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.cn511374-20240812-00435"},{"key":"e_1_2_9_15_1","unstructured":"Modify Blood Type Determination and Reporting Policies. [cited 2025 Nov 29]. Available from:https:\/\/optn.transplant.hrsa.gov\/media\/3545\/modify\u2010blood\u2010type\u2010determination\u2010and\u2010reporting\u2010policies\u2010jan\u20102020.pdf"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.21307\/immunohematology-2019-768"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/345229a0"},{"key":"e_1_2_9_18_1","unstructured":"American Association of Blood Banks.Standards for Blood Banks and Transfusion Services. 34th ed.; 5.12.AABB.2024."},{"key":"e_1_2_9_19_1","unstructured":"OPTN\/UNOS Operations and Safety Committee (OSC).Report to the Board of Directors November 12\u201313 2014. [cited 2025 Nov 28]. Available from:https:\/\/optn.transplant.hrsa.gov\/media\/1676\/osc_boardreport_20141112.pdf"},{"key":"e_1_2_9_20_1","unstructured":"Organ Procurement and Transplantation Network (OPTN).Policy 2: Deceased Donor Information. OPTN Policies. [cited 2025 Oct 4]. Available from:https:\/\/optn.transplant.hrsa.gov"},{"key":"e_1_2_9_21_1","unstructured":"Organ Procurement and Transplantation Network (OPTN).Policy 4.4: Critical HLA Discrepancies in Candidate Donor and Recipient HLA Typing Results. OPTN Policies. [cited 2026 Jan 13]. Available from:https:\/\/optn.transplant.hrsa.gov"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.70148","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/trf.70148","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.70148","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T03:27:31Z","timestamp":1778902051000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/trf.70148"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,7]]},"references-count":20,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1111\/trf.70148"],"URL":"https:\/\/doi.org\/10.1111\/trf.70148","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"value":"0041-1132","type":"print"},{"value":"1537-2995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,7]]},"assertion":[{"value":"2026-01-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}