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Aims: Blood grouping includes both forward and reverse typing and there is always an inverse reciprocal relationship between this. Any unusual reaction can confer discrepancy and may lead to grave incompatible transfusion reaction. Resolving discrepancy is a crucial part that should not be ignored to save patients life. Methods: It is a cross-sectional study carried out at a tertiary hospital, over a period of one year. Sample had been selected based on comprehensive history, medical records, physical findings, and laboratory reports. ABO and Rh typing was done by using monoclonal immunoglobulin M (IgM) reagents (Tulip, Lorne and Biorex Diagnostic Ltd.) and A, B, and pooled O cell. Therefore, anti-H and anti-A1 lectin, extended red cell phenotyping, Coombs analysis had also done in few suspected cases. Results: A total 25,082 blood group testing was done, 318 samples were carried out for group confirmation and discrepancy found in 51 cases. Technical and clerical errors were found in 18 cases. The remaining 33 samples reported as true discrepancy which was detected by Coombs analysis (both direct and indirect), antibody screening, determination of Rhesus genotype and phenotype, and minor antibody detection. The rate of discrepancy is about 0.20%. Meanwhile, missing antigen was found in 3 cases (5.88%), missing antibody in 1 (1.96%), additional reaction due to rouleaux’s in 4 (7.84%), mixed field (mf) reaction due to mismatched blood transfusion in 6 (11.76%), alloantibody with mixed phenotype in 5 (9.80%), cold antibody in 9 (17.24%), and Bombay in 5 cases (9.80%). Conclusion: Blood group discrepancy is not an uncommon phenomenon. All the critical issues should be sensibly explored, evaluated, and analyzed by the expert physicians to avoid the discrepancy. These common but curable issues can be easily carried out and solved. A careful surveillance can also play a significant role in monitoring the recuperate misidentification problem. Therefore, all the technical staffs who usually play these vital roles should be mannered and clarified in a successful motion, to avoid this type of discrepancies.

A close aspect of recognizing and resolving blood group discrepancy carried in a tertiary hospital, Bangladesh