{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T10:07:49Z","timestamp":1788775669081,"version":"build-2803163510"},"reference-count":11,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"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"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>H\u2010deficient states are important in ABO\u2010related transfusion practice. Patients may be misclassified as group O if testing stops at forward ABO typing. Anti\u2010IH may render group O units incompatible and increase hemolysis risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design and Methods<\/jats:title>\n                    <jats:p>A 70\u2010year\u2010old Iraqi man was referred for failure to obtain compatible blood before knee arthroplasty. ABO testing, crossmatching, antibody screening, anti\u2010H lectin testing, saliva inhibition and molecular analysis of fucosyltransferase 1 (FUT1) and fucosyltransferase 2 (FUT2) were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Forward grouping showed anti\u2010A\/anti\u2010B 0 (apparent O), with reverse grouping 4+ with A and B cells. Multiple group O units showed immediate 4+ incompatibilities at room temperature (RT). Antibody screening was pan\u2010reactive at RT, 37\u00b0C, and the antihuman globulin phase; the direct antiglobulin test and auto\u2010control were negative. Patient red blood cells were nonreactive with anti\u2010H lectin (Ulex europaeus), while control O cells reacted 4+. Cord O cells were nonreactive. Saliva inhibition demonstrated soluble H and B substances. Exome testing identified a homozygous FUT1 frameshift with wild\u2010type FUT2; the variant is deposited in ClinVar (Variation ID 4526453).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Based on Iraqi National Blood Transfusion Center records, this is the first documented molecularly characterized Para\u2010Bombay phenotype in Iraq. Apparent group O with O\u2010unit incompatibility should trigger anti\u2010H lectin testing, secretor evaluation, and molecular confirmation\/referral, underscoring the need for rare\u2010donor pathways.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.70390","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T09:11:31Z","timestamp":1788772291000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["First molecularly characterized Para\u2010Bombay phenotype in Iraq: Clinical, serological and genetic insights with implications for transfusion safety"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-6082-7227","authenticated-orcid":false,"given":"Dhargam Muhamed","family":"Aljebouri","sequence":"first","affiliation":[{"name":"Clinical Immunology and Allergy\u2014Specialized Immunosciences Laboratory Al\u2010Moayed Medical Network  Baghdad Iraq"},{"name":"Pusat Kanser Tun Abdullah Ahmad Badawi (PKTAAB), Universiti Sains Malaysia (USM)  Penang Malaysia"},{"name":"National Blood Transfusion Center Ministry of Health  Baghdad Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2505-2301","authenticated-orcid":false,"given":"Mohammed","family":"Aljadiri","sequence":"additional","affiliation":[{"name":"Clinical Immunology and Allergy\u2014Specialized Immunosciences Laboratory Al\u2010Moayed Medical Network  Baghdad Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bassam","family":"Alshaikhli","sequence":"additional","affiliation":[{"name":"National Blood Transfusion Center Ministry of Health  Baghdad Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rawa","family":"Alattabi","sequence":"additional","affiliation":[{"name":"National Blood Transfusion Center Ministry of Health  Baghdad Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arwa","family":"Alkhamess","sequence":"additional","affiliation":[{"name":"National Blood Transfusion Center Ministry of Health  Baghdad Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sajjad","family":"Aldoori","sequence":"additional","affiliation":[{"name":"National Blood Transfusion Center Ministry of Health  Baghdad Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9096-6898","authenticated-orcid":false,"given":"Yousif","family":"Suleiman","sequence":"additional","affiliation":[{"name":"Al\u2010Amiriyah General Hospital Al\u2010Anbar Health Directorate, Ministry of Health  Al\u2010Anbar Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Blood groups and red cell antigens [Internet]","author":"Dean L","year":"2005"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.1978.18679077959.x"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1006\/bbrc.1997.7232"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.91.13.5843"},{"key":"e_1_2_10_6_1","unstructured":"National Center for Biotechnology Information (NCBI).ClinVar; FUT1 variant Variation ID: 4526453 (VCV004526453.1). [cited 2026 Jun 9]. Available from:https:\/\/www.ncbi.nlm.nih.gov\/clinvar\/variation\/4526453\/"},{"key":"e_1_2_10_7_1","unstructured":"International Society of Blood Transfusion.Rare Donors | ISBT Working Party. [cited 2026 Jun 9]. Available from:https:\/\/www.isbtweb.org\/isbt-working-parties\/rare-donors.html"},{"issue":"2","key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1182\/blood.V90.2.839","article-title":"Wide variety of point mutations in the H gene of Bombay and para\u2010Bombay individuals that inactivate H enzyme","volume":"90","author":"Kaneko M","year":"1997","journal-title":"Blood"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2006.01045.x"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.1990.tb07800.x"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.htct.2022.08.004"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.17838"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.70390","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/trf.70390","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.70390","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T09:11:35Z","timestamp":1788772295000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/trf.70390"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,7]]},"references-count":11,"alternative-id":["10.1111\/trf.70390"],"URL":"https:\/\/doi.org\/10.1111\/trf.70390","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"value":"0041-1132","type":"print"},{"value":"1537-2995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,7]]},"assertion":[{"value":"2026-06-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"trf.70390"}}