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The universal blood recipient

Why AB positive accepts every red cell type, and why O is the universal plasma recipient

AB positive is the universal red cell recipient because its plasma has no anti-A, anti-B or anti-D antibodies. Learn how that works, its limits, and the reversed rule for plasma.

By BloodTypeCalc.com Editorial TeamPublished Suggest a correction

Quick answer

AB positive (AB+) is the universal red blood cell recipient. AB+ red cells already carry A, B and RhD antigens, so AB+ plasma contains none of the antibodies that would attack donor cells. AB+ people can therefore receive red cells from all eight types. For plasma, type O is the universal recipient.

Why AB positive can receive from anyone

Your immune system only makes ABO antibodies against antigens you lack. An AB+ person has both A and B antigens and the D antigen, so there is nothing left to make antibodies against. Whatever antigens a donor's red cells carry, the AB+ recipient's plasma will not react to them.

Red cell compatibility of AB positive
RecipientCan receive red cells from
AB+O−, O+, A−, A+, B−, B+, AB−, AB+ (all types)

What this means in practice

In practice, hospitals still give AB+ patients type-specific or closely matched blood when it is available, reserving the flexibility for shortages. AB+ is a relatively uncommon type, around 3 percent of the U.S. population, so AB+ patients benefit from being able to draw on the far larger supply of O and A blood.

Limits of the label

As with the universal donor, “universal” refers only to ABO and RhD. Antibodies to other blood group antigens (for example Kell or Duffy) can develop after previous transfusions or pregnancies, and a crossmatch is still performed whenever time allows.

The universal plasma recipient is O

For plasma the logic reverses. Type O red cells carry no A or B antigens, so no donor plasma's antibodies can attack them; O recipients can receive plasma from any ABO type. AB recipients, meanwhile, can only receive AB plasma. See the plasma compatibility guide.

Frequently asked questions

Is AB negative also a universal recipient?
Partly. AB− can receive red cells from any Rh-negative donor (O−, A−, B−, AB−) but should avoid Rh-positive cells, so it is a universal recipient for Rh-negative blood only.
Who can AB positive donate to?
AB+ red cells can only be given to other AB+ recipients, because every other type has antibodies against A, B or D. AB plasma, however, can be given to anyone.
Why are AB plasma donors valuable?
AB plasma has no anti-A or anti-B antibodies, making it the universal plasma donor. Because only about 4 percent of people are AB, blood services often specifically recruit AB donors for plasma donation.

Sources

Information on this page is paraphrased from the following authoritative sources.

  1. Facts About Blood and Blood Types(opens in a new tab)American Red Cross
  2. Blood typing(opens in a new tab)MedlinePlus, U.S. National Library of Medicine