What is the primary mechanism by which ABO incompatibility leads to hemolysis?

A Complement activation and membrane attack complex formation ✓
B Antibody-dependent cellular cytotoxicity
C Activation of coagulation cascade
D Release of inflammatory cytokines

Explanation

ABO incompatibility leads to the binding of pre-formed antibodies to the corresponding antigens on red blood cells, activating the complement system and resulting in hemolysis.

Source

Robbins and Cotran Pathologic Basis of Disease
Hematology Hematology: Blood Grouping and Crossmatching Hematology: Blood Grouping and Crossmatching Hard MEDICAL Confidence: high