Abstract: Objective For samples in the Rh blood group system that are found to contain antibodies with both anti-D and anti-C properties, further antibody identification should be performed to clarify their specificity, especially to exclude or confirm the presence of anti-G antibodies, and scientific and reasonable blood transfusion strategies should be explored in combination with clinical practice. Methods Identification of ABO and Rh blood types,unexpected antibody screening and identification, using CCdee and ccDEE cells as absorbent cells, A two - step absorption - elution test was adopted to separate and identify antibody specificity, and antibody titer was determined simultaneously. Results Anti-G, anti-D, and anti-C were detected in both patients, anti-E was additionally identified in patient 1, blood products with Rh phenotype ccdee and ABO compatibility were selected for cross-matching, and the cross-matching results were compatible. Conclusion For antibodies presenting with an anti-D + C serological reactivity profile, the presence of anti-G antibodies should be highly vigilant, as such antibodies often occur in combination with anti-D and anti-C. It is recommended that when transfusing blood to RhD-negative patients, blood products matched for both ABO and Rh system phenotypes (including C, c, D, E and e antigens) should be used whenever feasible, so as to reduce the risk of alloantibody production and ensure transfusion safety.

Key words: Anti-G, Anti-D, Anti-C, Anti-E, Absorption-elution test, Clinical blood transfusion