The Kell blood group system consists of 36 antigens carried on a type II transmembrane glycoprotein of 732 amino acids (aka CD238). The Kell glycoprotein is a zinc-dependent metalloproteinase that has been shown to have endothelin-3-converting enzyme activity. A single disulfide bond (Kell Cys72 - XK Cys347) links the KEL protein to the XK membrane protein that carries the Kx antigen. Absence of XK leads to a reduction of expression of Kell antigens on the red blood cell membrane.