Packed red blood cells red cells with both are called AB. Except in unusual cases like infants or seriously immunocompromised individuals, all people will have antibodies to any ABO blood type that isn't present on their own red blood cells, and will have an immediate hemolytic reaction to a unit that is not compatible with their ABO type. In addition to the A and B antigens, there are rare variations which can further complicate transfusions, such as the Bombay phenotype. The Rh blood group system consists of nearly around 50 different antigens, but the one of the greatest clinical interest is the "D" antigen,
ABO blood group system and likely predates human migration from Africa. The O01 allele is considered to predate the O02 allele. Some evolutionary biologists theorize that there are four main lineages of the ABO gene and that mutations creating type O have occurred at least three times in humans. From oldest to youngest, these lineages comprise the following alleles: "A101/A201/O09", "B101", "O02" and "O01". The continued presence of the O alleles is hypothesized to be the result of balancing selection. Both theories contradict the previously held theory that type O blood evolved first. It is possible that food and environmental antigens (bacterial, viral, or