Interdonor incompatibility due to anti-Kell antibody undetectable by automated antibody screening

A unit of whole donor blood, the plasma of which contained anti-Kell antibody, was transfused into a Kell-negative patient who had received a unit of Kell-positive blood 4 weeks previously. A haemolytic transfusion reaction ensued. The antibody had gone undetected in routine automated screening of the donor blood. Automated antibody detection techniques do not offer reliable detection of anti-Kell antibodies.