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 plant antigens) have epitopes similar enough to A and B glycoprotein antigens. The antibodies created against these environmental antigens in the first years of life can cross-react with ABO-incompatible red blood cells that it comes in contact with during blood transfusion later in life. Anti-A antibodies are hypothesized to originate from immune response towards influenza virus, whose epitopes are similar enough to the α-D-N-galactosamine on the A glycoprotein to be able to elicit a cross-reaction. Anti-B antibodies are hypothesized to originate from antibodies produced against Gram-negative bacteria, such as "E. coli", cross-reacting with the α-D-galactose on the B glycoprotein. However,