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Comprehensive and Detailed Explanation:

The ABO blood group system is determined by evaluating both forward and reverse typing results. Forward typing detects antigens present on the patient’s red blood cells, while reverse typing detects naturally occurring antibodies in the patient’s plasma. In this case, the patient’s cells react strongly with Anti-A reagent, indicating the presence of A antigen. There is no reaction with Anti-B, showing the absence of B antigen. The patient’s reverse typing demonstrates no agglutination with A1 cells, meaning anti-A antibodies are absent, while strong agglutination occurs with B cells, indicating the presence of anti-B antibodies. This pattern is characteristic of blood group A.

The positive reaction with Anti-D confirms the presence of the Rh(D) antigen, making the final interpretation A positive. Correct ABO and Rh typing is essential in transfusion medicine because incompatible transfusions can result in severe hemolytic transfusion reactions caused by antibodies attacking donor red blood cells. MLS professionals must accurately interpret forward and reverse typing together because discrepancies may indicate technical errors, weak antigens, unexpected antibodies, or patient conditions affecting antibody production.