{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T03:15:38Z","timestamp":1783653338910,"version":"3.55.0"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"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":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>ABO\u2010incompatible (ABOi) hematopoietic stem cell transplantation (HSCT) is often associated with ABO discrepancies post\u2010HSCT. Re\u2010emergence of the patient's original type post\u2010HSCT may signal graft loss, disease relapse, recent transfusion, or soluble ABO antigen. We present a group A pediatric patient with leukemia who underwent a minor ABOi HSCT from a group O donor with persistent and increasing A reactivity 2\u2009years post\u2010HSCT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The patient's electronic medical and laboratory records were reviewed. ABO, Lewis typing, and direct antiglobulin (DAT) tests were performed by column agglutination and\/or tube method. Soluble anti\u2010A was demonstrated by adsorption and human anti\u2010A neutralization. Elution of soluble A antigen was performed by incubation of patient red cells with group A\n                      <jats:sub>1<\/jats:sub>\n                      , Le(a\u2009+\u2009b\u2010) plasma.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The patient typed as Le(a\u2010b+) and demonstrated 1+ reactivity with anti\u2010A reagent, which increased (4+) during an episode of gastrointestinal graft\u2010versus\u2010host disease (GVHD). There was no evidence of disease relapse with 100% donor cells by molecular testing, normal blood counts, and a negative DAT. A high level of soluble A\u2010antigen in patient plasma was demonstrated by adsorption and anti\u2010A neutralization studies. Finally, soluble A antigen was successfully eluted from patient RBCs to reveal only group O donor type RBCs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>We present a case of persistent A antigen post\u2010ABOi HSCT due to soluble A antigen of patient origin. Soluble A antigen was demonstrated using adsorption, neutralization studies, and a modified elution method previously described for Lewis antigens. This case suggests increased soluble ABO antigen in the setting of gut GVHD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.70221","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T12:29:36Z","timestamp":1775824176000},"page":"1438-1443","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A case report of soluble A antigen confounding the blood type in a haplo\u2010identical hematopoietic stem cell transplant patient with graft\u2010versus\u2010host disease"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4423-651X","authenticated-orcid":false,"given":"Sheri","family":"Hugan","sequence":"first","affiliation":[{"name":"Michigan Medicine University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nada","family":"Naiyer","sequence":"additional","affiliation":[{"name":"Corewell Health  Grand Rapids Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0216-1599","authenticated-orcid":false,"given":"Laura","family":"Cooling","sequence":"additional","affiliation":[{"name":"Michigan Medicine University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,10]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/cells13100814"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2021006279"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0000000000002958"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.2478\/immunohematology-2024-013"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/176172a0"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/9780470987018"},{"key":"e_1_2_11_8_1","volume-title":"Judd's Methods in immunohematology","author":"Judd J","year":"2022"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1159\/000205828"},{"key":"e_1_2_11_10_1","first-page":"43S","article-title":"Use of flow cytometry for detecting uptake of A\/B blood group substance on 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