Modern Blood Banking & Transfusion Practices Seventh Edition Denise Harmening, PhD, MT(ASCP) 2025/2026 Update

,Antigen-Antibody Characteristic Chart*
ANTIGENS
Antigen RBC Antigen Antigen Antigen
Antigen Antigen ISBT Freq. % Expression Distrib. Demonstrates Modification
System Name Name W B at Birth Plasma/RBC Dosage Enzyme/Other
**D RH1 85 92 strong RBC only no Enz. 


**C RH2 68 27 strong RBC only yes Enz. 
**E RH3 29 22 strong RBC only yes Enz. 

**c RH4 80 97 strong RBC only yes Enz. 
**e RH5 98 99 strong RBC only yes Enz. 
Rh
ce/f RH6 64 92 strong RBC only no Enz. 
Ce RH7 70 27 strong RBC only no Enz. 
Cw RH8 1 rare strong RBC only yes Enz. 

G RH12 86 92 strong RBC only no Enz. 
V RH10 1 30 strong RBC only no Enz. 



VS RH20 1 32 strong RBC only no Enz.  AET → ZZAP →
K KEL1 9 rare strong RBC only occ Enz. → AET+  ZZAP ++


k KEL2 98.8 100 strong RBC only occ Enz. → AET+  ZZAP ++
Kpa KEL3 2 rare strong RBC only occ Enz. → AET+  ZZAP ++

Kell Kpb KEL4 99.9 100 strong RBC only occ Enz. → AET+  ZZAP ++
Jsa KEL6 .01 20 strong RBC only occ Enz. → AET+  ZZAP ++

Jsb KEL7 99.9 99 strong RBC only occ Enz. → AET+  ZZAP ++
†Kx — 99.9 99.9 weak RBC low occ Enz. → AET+  ZZAP ++



FYa FY1 65 10 strong RBC only yes Enz.  AET  ZZAP 



FYb FY2 83 23 strong RBC only yes Enz.  AET  ZZAP 
FY3 100 32 strong RBC only no Enz. → AET → ZZAP →
Duffy
FY5 100 32 expressed RBC only no Enz. → AET → ZZAP →
(on cord cells)
•FY6 100 32 expressed RBC only no Enz.  AET → ZZAP 
(on cord cells)




*This chart is to be used for general information only. Please refer to the appropriate chapter for more detailed information.
AET = 2-aminoethylisthiouronium bromide;  = enhanced reactivity; → = no effect;  = depressed reactivity; occ = occasionally; CGD = chronic granulomatious disease;
HDN = hemolytic disease of the newborn; HTR = hemolytic transfusion reaction; NRBC = non-red blood cell; RBC = red blood cell; WBC = white blood cell; ZZAP = dithiothreitol
plus papain.
• No human antibody to FY6 has been reported.
† It has been found that Kx is inherited independently of the Kell system; consequently it is no longer referred to as K15.
**Frequency in Asians: D 99%, C 93%, E 39%, c 47%, e 96%

,ANTIBODIES
Immunoglobin Clinical
Serology Comp. Class Optimum Significance
Stimulation Saline AHG Binding IgM IgG Temperature HTR HDN Comments
RBC occ yes no occ yes warm yes yes Very rarely IgA anti-D may be
produced; however, this is
invariably with IgG.
RBC occ yes no occ yes warm yes yes
RBC/NRBC occ yes no occ yes warm yes yes Anti-E may occur without
obvious immune stimulation.
RBC occ yes no occ yes warm yes yes
RBC occ yes no occ yes warm yes yes Warm autoantibodies may appear
to have anti-e-like specificity.
RBC occ yes no occ yes warm yes yes
RBC occ yes no occ yes warm yes yes
RBC/NRBC occ yes no occ yes warm yes yes Anti-Cw may occur without
obvious immune stimulation.
RBC occ yes no occ yes warm yes yes
RBC occ yes no occ yes warm yes yes Antibodies to V and VS can present
problems in the black population
where the antigen frequencies are in
the order of 30 to 32.
RBC occ yes no occ yes warm yes yes
RBC occ yes some occ yes warm yes yes Some antibodies to Kell antigens
have been reported to react poorly
in low ionic media.
RBC no yes no rarely yes warm yes yes
RBC no yes no no yes warm yes yes Kell system antigens are destroyed
by AET and by ZZAP.
RBC rarely yes no rarely yes warm yes yes
RBC rarely yes no rarely yes warm yes yes Anti-K1 has been reported to occur
following certain bacterial infections.
RBC no yes no no yes warm yes yes
RBC no yes no occ yes warm yes yes The lack of Kx expression on RBCs
and WBCs has been associated with
the McLeod phenotype and CGD.
RBC rare yes some rare yes warm yes yes Fya and Fyb antigens are destroyed by
enzymes. Fy (a–b–) cells are resistant
to invasion by P. vivax merozoites, a
malaria-causing parasite.
RBC rare yes some rare yes warm yes yes
RBC no yes rarely no yes warm yes yes FY3 and 5 are not destroyed by
enzymes.
RBC no yes ? no yes warm FY5 may be formed by interaction of
Rh and Duffy gene products.
FY6 was described using a mono-
clonal antibody which reacts
with most human red cells except
Fy(a–b–). This antigen is responsi-
ble for susceptibility of cells to
penetration by P. vivax.
(Continued on inside back cover)

, Modern
Blood Banking
& Transfusion
Practices
Seventh Edition

Denise Harmening, PhD, MT(ASCP)
Director of the Online Masters of Science in Clinical
Laboratory Management
Professor, Department of Medical Laboratory
Science
College of Health Sciences
Rush University
Chicago, Illinois, USA




Modern
Blood Banking & Transfusion Practices
Seventh Edition
Denise Harmening, PhD, MT(ASCP) 2025/2026 Update