Next to cold autoanti-I antibodies there can be antibodies directed against a combination of the I

antigen with another antigen with another that also consists of sugar molecules (ABO, P. Lewid)
these antibodies react only with erythrocytes that carry both antigens. Some examples are anti
HI,anti A, 1 , anti-BI and anti-P, I.

Anti-i is a rare IgM-antibody.This antibody haemolyses erythrocytes of adults with genotype ii

and erythrocytes of newborns.

Sometimes anti-i is found in the serum of patients with mononucleosis infectiosa,also known as
the kissing disease. The anti-i antibody disappears together with the clinical condition Anti-I and
anti-i are not relevant with regard to haemolytic disease of the newborn. Their significance for
blood transfusions is twofold, On the one hand they complicate antibody screenin and
crossmatch, on the other hand survival of incompatible erythrocytes in patients with powerful
cold autoagglutinins anti-I or anti-i is shortened, if they react at temperatures of 30 ° C or higher
,As autoantibodies they can cause intravasal agglutination and hemolysis of erythrocytes in small
blood vessels of the body that are exposed to air.

4.10 High frequency blood groups

Blood group antigens that are found in the population with a high to very high frequency are indicated as
HFA: High Frequency Antigens. The English term for these antigens is 'public antigens' and this term is
also used in Dutch literature. The frequency of the allele that codes for such HFAS is sometimes so high,
higher than 99%, that practically all individuals are positive for the antigen, Only a few individuals in the
population are negative for the said HFA antigens. Some examples of HFAs are: Vel, Lan, Yta, Coq, Ge2.

The gene that codes for an HFA has, in many cases, one allele of which the frequency in the population is
very high and, in addition, one (or more) allele (s) that hardly occurs (s) in the population. It is also
possible that besides the high-frequency allele, there is a silent allele of very frequency.

The blood group systems described above also contain a number of these HFAs. Known examples Kpb
and Jsb of the Kell system, Lub of the Lutheran system, P antigen from the Globoside collection and the I
antigen (in adults) from the li collection.

Antibodies directed against HFAs can cause major problems, because it is very difficult to compatible
donor erythrocytes for a patient who is negative for an HFA and has formed antio against it. Practically
all donors have the HFA on the red cell membrane. Therefore it is a store of blood from donors who are
negative for an HFA. A well-equipped bank of such rare blood is the SBFB (Sanquin Blood bank of
Frozen Blood), formerly the blood bank of frozen blood of thecouncil of th Europe.

HTLA

Antibodies directed against some of the HFAs show a special serological behavior. These antibodies react
to high titres, but the strength of the binding, the avidity, is low. These antibodies are called HTLA
antibodies, which stands for "High Titre Low Avidity". Whenever these HTLA antibodies are present in
the serum, the reaction pattern is striking: the serum reacts with incompatible red cells to a high dilution,
but all these positive reactions are weak, even those with the undiluted serum.Thus