Definition and research guide
This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.
Content available: 4 complete abstracts (770 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.
Definition
An antigenic mismatch between donor and recipient blood. Antibodies present in the recipient's serum may be directed against antigens in the donor product. Such a mismatch may result in a transfusion reaction in which, for example, donor blood is hemolyzed. (From Saunders Dictionary and Encyclopedia of Laboratory Medicine and Technology, 1984).
Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.
Also known as: Blood Group Incompatibilities; Incompatibilities, Blood Group; Incompatibility, Blood Group; Blood Type Incompatibility; Blood Type Incompatibilities; Incompatibility, Blood Type; Blood Group ABO Incompatibility; ABO Incompatibility.
Where it fits in the MeSH classification
- Broader topics
- Blood Physiological Phenomena; Immune System Phenomena
- Narrower topics
- Rh Isoimmunization
Research landscape
PubMed indexes 8,583 records tagged with the MeSH heading “Blood Group Incompatibility” (counts retrieved 2026-10-29). 684 of them (8.0%) were published from 2020 onward, and the busiest period so far is through 1999 with 4,994 records.
Reviews account for 975 records (11.4%) and meta-analyses for 41. Randomized controlled trials number 48 (0.6%) as a share of all records on the topic. Randomized trials make up only a small share of this literature, so much of what is known comes from laboratory, observational or descriptive work.
Show the data
| Period | Records |
|---|---|
| through 1999 | 4,994 |
| 2000-2009 | 1,406 |
| 2010-2019 | 1,499 |
| 2020 onward | 684 |
Publication-type chart data
| Type | Records | Share |
|---|---|---|
| Reviews | 975 | 11.4% |
| Meta-analyses | 41 | 0.5% |
| Randomized controlled trials | 48 | 0.6% |
Method: PubMed query "Blood Group Incompatibility"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-29.
Reading the evidence in immunology
Immune responses are studied in model organisms, in cells from donors and in patients, and the same pathway can behave differently across these settings. Mouse immune systems differ from human ones in important ways, and blood measurements may not reflect what happens in tissues. Clinical conclusions about immune-mediated disease or immunotherapy come mainly from controlled trials and long-term cohorts. Check the species and tissue studied, whether markers were linked to outcomes patients notice, and the follow-up time.
Evidence from open-access studies
These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.
| Study / authors | Year | Source label / design | Europe PMC citations | Licence / source |
|---|---|---|---|---|
| Hemolytic disease of the fetus and newborn due to Rh(D) incompatibility: A preventable disease that still produces significant morbidity and mortality in children | 2020 | Research article Design not recorded in structured metadata | 44 | cc by PMID 32687543 · DOI · PMC7371205 |
| Risk factors for RhD immunisation despite antenatal and postnatal anti-D prophylaxis | 2009 | Research article Design not recorded in structured metadata | 44 | cc by PMID 19538414 · DOI · PMC2774154 |
| FIGO/ICM guidelines for preventing Rhesus disease: A call to action | 2021 | Research article Design not recorded in structured metadata | 41 | cc by PMID 33128246 · DOI · PMC7898700 |
| The viability of ABO-incompatible kidney transplants: a single-center cohort in China | 2026 | Meta-analysis Design not recorded in structured metadata | 1 | cc by PMID 41782862 · DOI · PMC12953097 |
Hemolytic disease of the fetus and newborn due to Rh(D) incompatibility: A preventable disease that still produces significant morbidity and mortality in children [1]
Abstract reading summary — source excerpts
- Opening excerpt
- In the mid-20th century, Hemolytic Disease of the Fetus and Newborn, caused by maternal alloimmunization to the Rh(D) blood group antigen expressed by fetal red blood cells (i.
- Closing excerpt
- The global failure to provide this generally acknowledged standard-of-care to prevent Rh disease, even 50 years after its availability, contributes to an enormous, continuing burden of fetal and neonatal disease and provides a critically important challenge to the international health care system.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (236 words)
In the mid-20th century, Hemolytic Disease of the Fetus and Newborn, caused by maternal alloimmunization to the Rh(D) blood group antigen expressed by fetal red blood cells (i.e., "Rh disease"), was a major cause of fetal and neonatal morbidity and mortality. However, with the regulatory approval, in 1968, of IgG anti-Rh(D) immunoprophylaxis to prevent maternal sensitization, the prospect of eradicating Rh disease was at hand. Indeed, the combination of antenatal and post-partum immunoprophylaxis is ~99% effective at preventing maternal sensitization to Rh(D). To investigate global compliance with this therapeutic intervention, we used an epidemiological approach to estimate the current annual number of pregnancies worldwide involving an Rh(D)-negative mother and an Rh(D)-positive fetus. The annual number of doses of anti-Rh(D) IgG required for successful immunoprophylaxis for these cases was then calculated and compared with an estimate of the annual number of doses of anti-Rh(D) produced and provided worldwide. Our results suggest that ~50% of the women around the world who require this type of immunoprophylaxis do not receive it, presumably due to a lack of awareness, availability, and/or affordability, thereby putting hundreds of thousands of fetuses and neonates at risk for Rh disease each year. The global failure to provide this generally acknowledged standard-of-care to prevent Rh disease, even 50 years after its availability, contributes to an enormous, continuing burden of fetal and neonatal disease and provides a critically important challenge to the international health care system.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 32687543 · DOI · PMC7371205
Risk factors for RhD immunisation despite antenatal and postnatal anti-D prophylaxis [2]
Abstract reading summary — source excerpts
- Opening excerpt
- ObjectiveTo identify risk factors for Rhesus D (RhD) immunisation in pregnancy, despite adequate antenatal and postnatal anti-D prophylaxis in the previous pregnancy.
- Closing excerpt
- Hence, RhD immunisation may be further reduced by strict compliance to guidelines concerning determination of FMH and accordingly adjusted anti-D Ig prophylaxis, or by routine administration of extra anti-D Ig after a non-spontaneous delivery and/or a complicated or prolonged third stage of labour.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (226 words)
ObjectiveTo identify risk factors for Rhesus D (RhD) immunisation in pregnancy, despite adequate antenatal and postnatal anti-D prophylaxis in the previous pregnancy. To generate evidence for improved primary prevention by extra administration of anti-D Ig in the presence of a risk factor.DesignCase-control study.SettingNation-wide evaluation of the Dutch antenatal anti-D-prophylaxis programme.PopulationCases42 RhD-immunised parae-1, recognised by first-trimester routine red cell antibody screening in their current pregnancy, who received antenatal and postnatal anti-D Ig prophylaxis (gifts of 1000 iu) in their first pregnancy.Controls339 parae-1 without red cell antibodies.MethodsData were collected via obstetric care workers and/or personal interviews with women.Main outcome measureSignificant risk factors for RhD immunisation in multivariate analysis.ResultsIndependent risk factors were non-spontaneous delivery (assisted vaginal delivery or caesarean section) (OR 2.23; 95% CI:1.04-4.74), postmaturity (>or=42 weeks of completed gestation: OR 3.07; 95% CI:1.02-9.02), pregnancy-related red blood cell transfusion (OR 3.51; 95% CI:0.97-12.7 and age (OR 0.89/year; 95% CI:0.80-0.98). In 43% of cases, none of the categorical risk factors was present.ConclusionsIn at least half of the failures of anti-D Ig prophylaxis, a condition related to increased fetomaternal haemorrhage (FMH) and/or insufficient anti-D Ig levels was observed. Hence, RhD immunisation may be further reduced by strict compliance to guidelines concerning determination of FMH and accordingly adjusted anti-D Ig prophylaxis, or by routine administration of extra anti-D Ig after a non-spontaneous delivery and/or a complicated or prolonged third stage of labour.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 19538414 · DOI · PMC2774154
FIGO/ICM guidelines for preventing Rhesus disease: A call to action [3]
Abstract reading summary — source excerpts
- Opening excerpt
- The introduction of anti-Rh(D) immunoglobulin more than 50 years ago has resulted in only a 50% decrease in Rhesus disease globally owing to a low uptake of this prophylactic approach.
- Closing excerpt
- Taking into account the effectiveness anti-Rh(D), the new guidelines propose adjusting the dose for different indications and prioritizing its administration by indication.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (80 words)
The introduction of anti-Rh(D) immunoglobulin more than 50 years ago has resulted in only a 50% decrease in Rhesus disease globally owing to a low uptake of this prophylactic approach. The International Federation of Gynecology and Obstetrics, International Confederation of Midwives, and Worldwide Initiative for Rhesus Disease Eradication have reviewed current evidence regarding the utility of anti-Rh(D) immunoglobulin. Taking into account the effectiveness anti-Rh(D), the new guidelines propose adjusting the dose for different indications and prioritizing its administration by indication.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 33128246 · DOI · PMC7898700
The viability of ABO-incompatible kidney transplants: a single-center cohort in China [4]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundABO-incompatible living donor kidney transplantation (ABOi-LDKT) offers a potential solution to organ shortages, but its safety and economic impact in China remain uncertain.
- Closing excerpt
- When combined with contemporary desensitization protocols, ABOi-LDKT appears to be a safe and feasible strategy to expand access to living donor kidney transplantation in settings with severe organ shortages.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (228 words)
BackgroundABO-incompatible living donor kidney transplantation (ABOi-LDKT) offers a potential solution to organ shortages, but its safety and economic impact in China remain uncertain. This study evaluated short- to mid-term outcomes of ABOi-LDKT in a Chinese population by integrating evidence from a meta-analysis and a single-center cohort.MethodsWe performed a meta-analysis of 18 studies including 15,611 kidney transplant recipients to compare graft and patient survival between ABOi-LDKT and ABO-compatible LDKT (ABOc-LDKT). In parallel, we conducted a retrospective single-center cohort study of 41 ABOi-LDKT and 132 ABOc-LDKT recipients transplanted between 2021 and 2022. Outcomes included patient and graft survival, renal function, postoperative complications, infections, delayed graft function (DGF), acute rejection, and hospitalization costs.ResultsThe meta-analysis showed lower 1-year graft survival and 3-year patient survival in ABOi-LDKT than in ABOc-LDKT. In contrast, our single-center cohort demonstrated comparable 1- and 3-year patient and graft survival between groups. No significant differences were observed in surgical complications, infections, DGF, or acute rejection. ABOi-LDKT recipients showed better renal function at two weeks post-transplant, with no sustained differences thereafter. Hospitalization costs were higher in the ABOi-LDKT group, reflecting additional desensitization procedures.ConclusionIn this Chinese single-center cohort, ABOi-LDKT achieved short- to mid-term clinical outcomes comparable to ABOc-LDKT despite higher upfront costs. When combined with contemporary desensitization protocols, ABOi-LDKT appears to be a safe and feasible strategy to expand access to living donor kidney transplantation in settings with severe organ shortages.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41782862 · DOI · PMC12953097
Key reviews and meta-analyses
The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.
- Research article Red blood cell alloimmunization in sickle cell disease: pathophysiology, risk factors, and transfusion management [5]
- Research article Neonatal hyperbilirubinemia and Rhesus disease of the newborn: incidence and impairment estimates for 2010 at regional and global levels [6]
- Research article Transfusion-related red blood cell alloantibodies: induction and consequences [7]
- Research article ABO-incompatibility in solid organ transplantation [8]
- Research article ABO-Incompatible Kidney Transplant Outcomes: A Meta-Analysis [9]
- Research article Fetal anemia due to non-Rhesus-D red-cell alloimmunization [10]
References
- Pegoraro V, Urbinati D, Visser GHA, Di Renzo GC, Zipursky A, Stotler BA, et al.. Hemolytic disease of the fetus and newborn due to Rh(D) incompatibility: A preventable disease that still produces significant morbidity and mortality in children. . 2020. PMID 32687543 · DOI · PMC7371205
- Koelewijn JM, de Haas M, Vrijkotte TG, van der Schoot CE, Bonsel GJ. Risk factors for RhD immunisation despite antenatal and postnatal anti-D prophylaxis. . 2009. PMID 19538414 · DOI · PMC2774154
- Visser GHA, Thommesen T, Di Renzo GC, Nassar AH, Spitalnik SL, FIGO Committee for Safe Motherhood, et al.. FIGO/ICM guidelines for preventing Rhesus disease: A call to action. . 2021. PMID 33128246 · DOI · PMC7898700
- Chen Y, Pan J, Li D, Wang K, Ding H, Zhang F, et al.. The viability of ABO-incompatible kidney transplants: a single-center cohort in China. . 2026. PMID 41782862 · DOI · PMC12953097
- Yazdanbakhsh K, Ware RE, Noizat-Pirenne F. Red blood cell alloimmunization in sickle cell disease: pathophysiology, risk factors, and transfusion management. Blood. 2012. PMID 22563085 · DOI · PMC3401213
- Bhutani VK, Zipursky A, Blencowe H, Khanna R, Sgro M, Ebbesen F, et al.. Neonatal hyperbilirubinemia and Rhesus disease of the newborn: incidence and impairment estimates for 2010 at regional and global levels. Pediatr Res. 2013. PMID 24366465 · DOI · PMC3873706
- Tormey CA, Hendrickson JE. Transfusion-related red blood cell alloantibodies: induction and consequences. Blood. 2019. PMID 30808636 · DOI · PMC6484385
- Rydberg L. ABO-incompatibility in solid organ transplantation. Transfus Med. 2001. PMID 11532188 · DOI
- de Weerd AE, Betjes MGH. ABO-Incompatible Kidney Transplant Outcomes: A Meta-Analysis. Clin J Am Soc Nephrol. 2018. PMID 30012630 · DOI · PMC6086717
- Moise KJ. Fetal anemia due to non-Rhesus-D red-cell alloimmunization. Semin Fetal Neonatal Med. 2008. PMID 18396474 · DOI
About this article
- Sources
- NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
- Verification
- Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
- Review state
- automated source verified; no human expert review has been recorded yet.
- Version
- 1, last updated 2026-10-29.
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Evidence strength
EvidenceHelix's computed view of the study designs behind this topic: how common meta-analyses, randomized trials and reviews are, how recent the literature is, and a plain-language reading. It describes the design mix of the literature. It is not a quality appraisal of any study, and it is not medical advice.