Abstract: Objective To explore the causes and analyze the molecular biology of ABO typing discrepancy in patients of Tujia and Miao nationalities in Enshi. Methods Totally 59 cases of ABO typing discrepancy samples taken in our hospital from October 2018 to October 2022 were retrospectively investigated. The absorption and release tests, accidental antibody detection, and molecular biology testing were performed on the samples to examine the reasons for ABO typing discrepancy, and the serological and molecular biological testing results were compared. Results Among the 59 samples, there were 8 (13.56%) cases of positive stereotype abnormalities, 47 (79.66%) negative, and 4 (6.78%) both positive and negative. The proportion of males (62.71%, 37/59) was higher than that of females (37.29%, 22/59) (P<0.05). The proportion of the ≥61-year-old group (42.37%, 25/59) was higher than that of the 41-50-year-old group (32.20%, 19/59) and that of the 51-60-year-old group (25.42%, 15/59) (P<0.05). Twelve (70.6%) of the 17 ABO subtype samples were of Turkish origin. Among the 59 cases of ABO typing discrepancy, 29 (49.16%) were unexpected antibodies, 17 (28.81%) ABO subtypes, and 13 (22.03%) serum antibodies weakened. Among the 17 ABO subtypes, there were 6 cases of subtype A (1 case of A2 type, 4 cases of A3 type, 1 case of Ael type), 4 cases of subtype B (3 cases of B3 type, 1 case of Bel type), 2 cases of AB3 type, 3 cases of subtype B (A type), and 2 cases of cisAB type. Among the 17 ABO subtypes, 8 serological results were consistent with genotyping results, with a concordance rate of 47.1% (8/17). The A307/O02 genotype was dominant in subtype A, and the B303/O02 genotype in subtype B. Conclusion After excluding the physiological, pathological and experimental factors, the ABO subtype is the main cause of ABO typing discrepancy in the Tujia and Miao populations of Enshi. Among the subtypes, the A307/O02 genotype is the main type in subtype A, and the B303/O02 genotype is the main type in subtype B.

Key words: ABO blood type, ABO typing discrepancy, Saline test tube method, Absorption and dissipation test, Genotyping