The Clinical Significance of Anti‐H in an Individual with the Oh (Bombay) Phenotype

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Abstract
To evaluate the clinical significance of anti-H present in individuals with the Oh (Bombay) phenotype, red blood cell [RBC] 51Cr survival studies and related serological tests were undertaken in an Oh (Bombay) individual. A small sample of group O donor RBC was labeled with 51Cr and infused into the patient. The T1/2 [half-life] of the infused cells was 6 min with 2% of the cells surviving at 24 h. A similar study using the patient''s own labeled RBC demonstrated 100% survival at 24 h initial laboratory studies indicated that the anti-H was active in saline at 4, 22 and 37.degree. C and by the indirect antiglobulin test. Analysis of the antibody [Ab] in pre- and post-transfusion specimens showed it to have Ig[immunoglobulin]M and IgG components. The anti-H titer at 37.degree. C rose from 1:4 prior to the infusion of the O cells to 1:32 1 wk post-infusion, and a partial hemolysin appeared. Saliva inhibition studies demonstrated that the Ab was neutralizable prior to the group O exposure but was not neutralizable 1 wk post exposure. The anti-H present in this individual rapidly destroyed infused group O RBC. Individuals with the Oh (Bombay) phenotype should be transfused only with Oh (Bombay) blood.