A rare Bombay (Oh) phenotype to 'A' blood group – Live donor liver transplant

Bombay (Oh) phenotype is the rarest blood group in India characterized by the absence of A, B, and H antigens and the presence of anti-H antibodies besides anti-A and anti-B. There is no literature predicting the safety of Oh blood group organ donation to non-Oh blood group recipient. We present the first reported case of successful live donor liver transplantation from an Oh-positive liver donor to an A-positive blood group recipient with hepatitis B virus-related chronic liver disease. The case highlights the need for proper immunohematological workup, national registry of rare group blood donors and need of protocol for perioperative monitoring and blood management in ABO-incompatible organ transplants involving Oh group donor or recipient.