Packed red blood cells do not have an antibody, since the greatest risk of Rh incompatible blood is to current or future pregnancies. For RBCs, type O negative blood is considered a "universal donor" as recipients with types A, B, or AB can almost always receive O negative blood safely. Type AB positive is considered a "universal recipient" because they can receive the other ABO/Rh types safely. These are not truly universal, as other red cell antigens can further complicate transfusions. There are many other human blood group systems and most of them are only rarely associated with transfusion problems. A screening test is
Blood type individuals with hh antigen system (also known as the Bombay phenotype) who can only receive blood safely from other hh donors, because they form antibodies against the H antigen present on all red blood cells. Blood donors with exceptionally strong anti-A, anti-B or any atypical blood group antibody may be excluded from blood donation. In general, while the plasma fraction of a blood transfusion may carry donor antibodies not found in the recipient, a significant reaction is unlikely because of dilution. Additionally, red blood cell surface antigens other than A, B and Rh D, might cause adverse reactions and sensitization,