Abstract.A group B recipient of a group 0 kidney developed severe intravascular haemolysis due to the formation of anti‐B. Immunoglobulin allotyping of donor serum, recipient serum and ‘unexpected’ anti‐B antibody showed the antibody to be of donor origin. The patient and donor genotypes were Gm 3;5/3;5 and Gm 1,2;21/1;21, respectively, and the anti‐B antibody allotype was Gm 1;21. The group B recipient of the other donor kidney showed no evidence of haemolysis. Possible factors influencing the occurrence and severity of post‐transplantation haemolysis are discussed. The production of anti‐A or anti‐B antibodies in non‐group 0 patients who receive group 0 organ transplants is well described [1–8]. We report a case of severe intravascular haemolysis in a group B patient who received a group 0 kidney, together with immunoglobulin allotyping studies which show conclusively that the antibody responsible for the haemolysis
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