> Minor antigens come into play when crossmatching for infants

I’m reminded of that American high schooler in Uganda running an orphanage and ran into this exact issue when doing a transfusion on a malnourished infant. [1]

She was skilled enough to perform a transfusion and knowledgeable enough to test for a ABO+/- match but not so knowledgeable as to be sensitive to this issue with disastrous results.

On the other hand her clinics metrics were on par or slightly above the local hospitals so it’s not clear to me they would have faired better getting care elsewhere there.

[1] https://stories.showmax.com/za/hbos-docuseries-savior-comple...

I don't know anything about the case in Uganda, but transfusion reactions can happen to anyone, even in the United States.

We don't actually express antibodies to antigens until we're exposed to them, so crossmatching won't detect a minor antigen mismatch until the first transfusion containing the antigen is administered.

That first time causes a delayed hemolytic transfusion reaction, which is generally milder than the kind of reaction crossmatching will prevent, but can be serious or even fatal.

https://en.wikipedia.org/wiki/Delayed_hemolytic_transfusion_...