{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T06:47:02Z","timestamp":1782197222382,"version":"3.54.5"},"reference-count":42,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","award":["09\/17540\u20102"],"award-info":[{"award-number":["09\/17540\u20102"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","award":["11\/08075\u20104"],"award-info":[{"award-number":["11\/08075\u20104"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Mixed\u2010field (MF) reactivity in ABO typing has historically been associated with the A\n                      <jats:sub>3<\/jats:sub>\n                      subgroup, but whether MF reflects a subgroup\u2010specific finding or a quantitative serologic phenomenon, and what mechanisms underlie it across contexts, remains uncertain.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design and Methods<\/jats:title>\n                    <jats:p>A prospective analysis was performed on 30 individuals referred for ABO discrepancies with MF reactivity from Brazilian institutions between 2019 and 2025. The cohort included donors, newborns, and patients with hematologic disorders. Serologic evaluation included routine column agglutination testing, MF separation techniques, and systematic assessment with monoclonal anti\u2010A, anti\u2010B, and anti\u2010A,B reagents from different clones at predefined titers (1:512\u20131:2048). Complete ABO gene sequencing was performed in all cases, and serologic and molecular findings were integrated to determine the mechanism of each discrepancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All samples showed weak ABO antigen expression with MF patterns, predominantly graded as 1+ to 2+ in gel testing. Reactivity varied by antibody clone and titer, and weak reactions frequently shifted to MF or stronger agglutination as reagent concentration increased. Discrepancies were attributed to ABO genetic variants in 50% of cases, neonatal immaturity in 23%, disease\u2010related conditions in 13%, biological mechanisms in 7%, and analytical interference in 7%. Higher\u2010titer monoclonal reagents improved weak A\/B detection across all categories, achieving complete phenotype\u2013genotype concordance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Mixed\u2010field reactivity is a quantitative manifestation of reduced ABO antigen expression rather than a discrete subgroup\u2010defining characteristic. A selected panel of higher\u2010titer monoclonal antibodies may improve diagnostic accuracy and guide supplementary serologic and molecular investigation in unresolved or clinically relevant ABO discrepancies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.70302","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T05:57:38Z","timestamp":1782194258000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mixed\u2010field reactivity in the\n                    <scp>ABO<\/scp>\n                    blood group system: A quantitative manifestation of weak antigen expression"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9948-5874","authenticated-orcid":false,"given":"Marcos Paulo","family":"Miola","sequence":"first","affiliation":[{"name":"Department of Dermatological, Infectious and Parasitic Diseases Faculty of Medicine of S\u00e3o Jose do Rio Preto\u2014FAMERP  S\u00e3o Paulo Brazil"},{"name":"Regional Blood Center of S\u00e3o Jos\u00e9 do Rio Preto, Immunohematology Laboratory and Transfusion Service, Hospital de Base (FUNFARME)  S\u00e3o Jos\u00e9 do Rio Preto S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oct\u00e1vio","family":"Ricci Junior","sequence":"additional","affiliation":[{"name":"Regional Blood Center of S\u00e3o Jos\u00e9 do Rio Preto, Immunohematology Laboratory and Transfusion Service, Hospital de Base (FUNFARME)  S\u00e3o Jos\u00e9 do Rio Preto S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8572-8177","authenticated-orcid":false,"given":"Luiz Carlos","family":"de Mattos","sequence":"additional","affiliation":[{"name":"Department of Dermatological, Infectious and Parasitic Diseases Faculty of Medicine of S\u00e3o Jose do Rio Preto\u2014FAMERP  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"ISBT Blood Group Database [Internet]. 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