Titres of alloantibodies against A and B blood types in non-pedigree domestic cats in Turkey: Assessing the transfusion reaction risk

Wild Felids Blood Group System

Wild felids and domestic cats share the AB blood group. However, there have been few studies regarding the characterization and prevalence of the different blood types in wild animals. The erythrocyte membrane glycolipids of the wild cats correspond to the major disialoganglioside patterns observed in domestic cats. Like in domestic cats, type A blood seems to be the most common, although wild felid species seem to exhibit one single blood type. Of the species studied, the wild domestic cats, and the Panthera and ocelot lineages, all had type A blood; the Puma lineage showed almost exclusively type B blood. The prevalence of wild felids blood types show that there seems to be variation between species, but not within species, and no evidence of geographical variation has yet been found, showing apparently no genetic variability. The presence of alloantibodies has also been demonstrated, so the risk of life-threatening transfusion reactions due to mismatched transfusions and neonatal isoerythrolysis is a possibility. Like in other species, the recognition of wild felids blood groups is clinically relevant, as it can also be important in establishing phylogenetic relationships within the Felidae family. We will review the current knowledge on this topic and give insights into the wild felids blood groups potential for zoo transfusion medicine and phylogenetic studies in order to help support reintroduction projects and to preserve genetic diversity.

Feline Blood Groups: A Systematic Review of Phylogenetic and Geographical Origin

Simple Summary

Numerous breeds have been identified in the domestic cat, grouped according to their phylogenetic or geographical origin. In the cat, the AB blood group system is the most important feline system, and the determination of the blood group by specific methods is an essential step to avoid or reduce the risk of an adverse reaction in the recipient patient. Many studies have been published on the distribution and prevalence of blood types in pedigree and non-pedigree cats, but the information has never been collated in a systematic manner.

Abstract

Domestic cats descended from the African wildcat several thousand years ago. Cats have spread to all parts of the world, probably along routes between civilizations or geographical boundaries, leading to the movement of species, from Asia to the African continent through the Mediterranean basin, and finally to the American continent, Australia, and New Zealand. Currently, 73 cat breeds are recognized by the International Cat Association. With the increasing interest in the selection of breeds, the determination of blood groups in cats has acquired importance over time. The AB blood group system is the most important blood system in cats, in which A, B, and AB or C blood groups are identified. This systematic review describes data from previously published reports about cat blood types and cat breeds. After applying specific criteria, 28 eligible studies were identified in which the prevalence percentages for each blood group in correlation with specific cat breeds were reported. The breeds were, in turn, divided into four groups according to their geographic and phylogenetic origins as follows: Asian cat breeds, American cat breeds, European cat breeds, and breeds from Oceania. Although numerous studies were carried out before 2021, gaps in the literature on the AB system and, in particular, the Mik group are highlighted.

Association of Veterinary Hematology and Transfusion Medicine (AVHTM) Transfusion Reaction Small Animal Consensus Statement (TRACS) Part 2: Prevention and monitoring

OBJECTIVE

To systematically review available evidence to develop guidelines for the prevention of transfusion reactions and monitoring of transfusion administration in dogs and cats.

DESIGN

Evidence evaluation of the literature (identified through Medline searches through Pubmed and Google Scholar searches) was carried out for identified transfusion reaction types in dogs and cats. Evidence was evaluated using PICO (Population, Intervention, Comparison, Outcome) questions generated for each reaction type. Evidence was categorized by level of evidence (LOE) and quality (Good, Fair, or Poor). Guidelines for prevention and monitoring were generated based on the synthesis of the evidence. Consensus on the final recommendations and a proposed transfusion administration monitoring form was achieved through Delphi-style surveys. Draft recommendations and the monitoring form were made available through veterinary specialty listservs and comments were incorporated.

RESULTS

Twenty-nine guidelines and a transfusion administration monitoring form were formulated from the evidence review with a high degree of consensus CONCLUSIONS: This systematic evidence evaluation process yielded recommended prevention and monitoring guidelines and a proposed transfusion administration form. However, significant knowledge gaps were identified, demonstrating the need for additional research in veterinary transfusion medicine.

Frequency of Blood Types A, B and AB in a Population of Non-Pedigree Domestic Cats from Central Italy

Simple Summary

This study aimed to evaluate the frequency of AB blood groups in non-pedigree domestic cats in Central Italy. The presence of natural alloantibodies in the feline blood group system can cause life-threatening transfusion reactions due to mismatched transfusion and, depending on the parents’ blood type, can also account for hemolytic reactions in newborn kittens. Based on the frequency of the AB blood groups found in the 483 cats studied, a potential risk (6.5%) of acute hemolytic transfusion or neonatal reactions was calculated. Therefore, determining the blood group in non-pedigree domestic cats from Central Italy before transfusion is strongly recommended, as has been reported for other geographical areas. Moreover, particular attention should be paid to the mating of non-purebred cats.

Abstract

Blood transfusion reactions and neonatal isoerythrolysis are common events in the feline population due to the presence of natural alloantibodies in the AB blood group system. It is known that the frequency of feline blood types varies according to the geographic region and breed. Therefore, the aims of this study were to investigate the frequency of AB blood groups in non-pedigree domestic cats in Central Italy and estimate the risk of a life-threatening transfusion reaction and neonatal isoerythrolysis, caused by mismatched transfusion or incompatible random mating, respectively. The AB blood group was determined on non-pedigree domestic feline patients and potential blood donors submitted at the Veterinary Teaching Hospitals of the Universities of Teramo (Abruzzo Region, Teramo, Italy) and Perugia (Umbria Region, Teramo, Italy), and visited at veterinary practitioners in Rome (Lazio Region, Teramo, Italy) using commercial immunochromatographic cartridges and commercial agglutination cards. There were four hundred and eighty-three cats included in the study. The frequencies of the blood types were: 89.9% type A, 7.0% type B, and 3.1% type AB. The probability of an acute hemolytic transfusion reaction or a neonatal isoerythrolysis was 6.5%. Although the frequency of type B in non-pedigree domestic cats living in Central Italy was relatively low, to reduce the risk of fatal transfusion reactions, blood group typing is recommended before each transfusion.

Prevalence of Blood Types and Alloantibodies of the AB Blood Group System in Non-Pedigree Cats from Northern (Lombardy) and Southern (Sicily) Italy

Simple Summary

The most important blood group system in cats is the AB, in which cats are classified as type-A, B or AB. Cats have antibodies against the blood type they do not possess, called alloantibodies. The aims of this study were to update blood type prevalence in cats from Northern Italy and study for the first time the blood type in cats from an insular region of Southern Italy, Sicily; to detect alloantibodies in these feline populations; to compare results with previous studies performed in Italy and between regions in Northern and Southern Italy. Cats from Southern Italy had the highest prevalence of type-B and type-AB, and the lowest prevalence of type-A blood in Italy. In particular, type-AB prevalence was higher than all previous reports in non-pedigree cats in Europe and the Italian prevalence of anti-type-B alloantibodies in type-A cats was the lowest reported worldwide. These results highlight the usefulness of regional studies to report different prevalences in feline blood types. Compatibility tests such as blood typing and cross matching must be considered fundamental in cats of any origin to ensure safe and efficient blood transfusion and to prevent neonatal isoerythrolysis.

Abstract

The aims of this study were to determine the prevalence of A, B and AB blood types and alloantibodies in non-pedigree cats from two regions, one in Northern and one in Southern Italy (Lombardy and Sicily, respectively). A total of 448 samples (52.0% from Northern and 48.0% from Southern Italy) were blood typed. The prevalence of A, B and AB blood types in northern and southern cats were 91.0%, 5.2%, 3.8%, and 77.2%, 12.1% and 10.7%, respectively. The prevalence of type-A blood in southern cats was significantly lower (p = 0.0001) than in northern cats, while type-B and AB blood were significantly higher (p = 0.0085 and p = 0.0051, respectively) in Southern compared to Northern Italian cats. Alloantibodies against type-A blood were found in 94.1% of type-B cats, 11.2% of type-A cats had alloantibodies against type-B blood, while no type-AB cats had alloantibodies with no significant difference between the two Italian populations. Type-AB prevalence in non-pedigree cats in Southern Italy was the highest reported in Europe. Italian type-A cats had the lowest worldwide prevalence of alloantibodies against type-B blood. These results highlight the usefulness of regional studies to report different prevalences in feline blood types and reinforce the importance of blood typing cats before transfusions and mating.

The Prevalence of Blood Groups in Domestic Cats in the Saskatoon and Calgary Areas of Saskatchewan and Alberta, Canada

The purpose of this study was to evaluate blood types of domestic cats in two cities in Western Canada (Saskatoon, Saskatchewan and Calgary, Alberta), as well as to determine the risk of mismatched transfusion and neonatal isoerythrolysis. Several cat studies around the world have shown variability in the prevalence of blood types in domestic and pedigree cats. Canadian data based on feline blood types is based out of Montreal. In this study the cohort of cats revealed a higher than anticipated prevalence; of 5% type B and 0.6% AB blood types. In our study, blood typing was performed in 400 domestic cats; 200 in Saskatoon and 200 in Calgary. Blood typing was performed using the gel tube method and the risk of transfusion mismatch (MT) was estimated by adding the risk of a major transfusion reaction and the risk of a minor transfusion reaction. The risk of neonatal isoerythrolysis (NI) was estimated according to the equation (p²)(q²) + 2pq(q²), with q being the b allele frequency and p = 1 – q. There was an identical frequency for feline blood types in both Saskatoon and Calgary cats, with 96% type A, 4% type B, and 0% AB. Based on these percentages, the risks of MT and NI in domestic cats were 7.6 and 4 % respectively. The frequency of type B cats in the population was similar to that in the previous Canadian study. These results demonstrate regional differences in prevalence of type B blood in domestic shorthairs across the world and serve to reinforce recommendations to blood type prior to transfusion or mating.

Assessment of risks of feline mismatched transfusion and neonatal isoerythrolysis in the Lyon (France) area

Objectives

The aims of this study were to update the prevalence of different feline blood types in the Lyon (France) area, as well as to determine the risk of mismatched transfusion (MT) and neonatal isoerythrolysis (NI) in kittens with parents of unknown blood type.

Methods

Blood samples were obtained from blood donor cats and cats admitted to an intensive care unit in Lyon. AB blood typing was performed using an immunochromatographic strip. The risk of MT was estimated by adding the risk of a major transfusion reaction and the risk of a minor transfusion reaction. The risk of NI was estimated according the equation (p²)(q²) + 2pq(q²), with q being the b allele frequency and p = 1 - q. The results were analysed by absolute and relative frequency analysis and multivariate analysis.

Results

The cohort study population included 320 non-pedigree cats and 37 pedigree cats. The prevalence of blood types A, B and AB was 84.3%, 14.0% and 1.7%, respectively. Considering non-pedigree cats, the prevalence of types A, B and AB was 83.7%, 14.4% and 1.9%, respectively. There were no significant differences of blood type distribution by sex (P = 0.73) or by breed (P = 0.90). Based on these percentages, the risks of MT and NI in non-pedigree cats were 24.3% and 12.3%, respectively.

Conclusions and relevance

The prevalence of type B cats is high in the Lyon area and associated with high risks of MT and NI. These results confirm the importance of performing blood typing prior to any blood transfusion or mating.

Prevalence of naturally occurring non-AB blood type incompatibilities in cats and influence of crossmatch on transfusion outcomes

BACKGROUND

Recognition of the feline red blood cell (RBC) antigen Mik and the presence of naturally occurring anti-Mik antibodies resulting in acute hemolytic transfusion reactions prompted the recommendation to perform a crossmatch before a cat's first RBC transfusion, but this guideline has not yet become a standard practice.

OBJECTIVE

To determine the prevalence of naturally occurring non-AB alloantibodies detectable by tube crossmatch, and to compare transfusion outcomes in cats with and without a crossmatch performed.

ANIMALS

Three hundred cats that received an RBC transfusion, with or without a major crossmatch performed.

METHODS

Retrospective study.

RESULTS

Major crossmatch incompatibilities were documented in 23 of 154 transfusion-naive cats (14.9%) and in 15 of 55 previously transfused cats (27%; P = 0.042). Type-specific packed RBCs (pRBCs) were administered to 167 and 82 cats with and without a crossmatch, respectively. Median volume of pRBCs administered during the first transfusion was 5.3 mL/kg (range, 2.4-18 mL/kg). Median change in PCV scaled to dose of pRBCs was +0.8%/mL/kg; administration of crossmatch-compatible pRBCs was not associated with a greater increase in PCV. Febrile transfusion reactions occurred more often in cats that received non-crossmatched (10.1%) compared to crossmatched (2.5%) pRBCs (P = 0.022). Seventy-six percent of cats that received pRBC transfusions survived to hospital discharge. A crossmatch was not associated with improved survival to discharge or at 30 or 60 days posttransfusion.

CONCLUSIONS AND CLINICAL IMPORTANCE

The prevalence of naturally occurring non-AB incompatibilities is sufficiently high to justify the recommendation to perform a crossmatch before all (including the first) RBC transfusions in cats.

Distribution of feline AB blood types: a review of frequencies and its implications in the Iberian Peninsula

Objectives

The objective of this study was to document the prevalence of feline blood types in the Iberian Peninsula and to determine the potential risk of incompatibility-related transfusion reactions in unmatched transfusions and the potential risk of neonatal isoerythrolysis (NI) in kittens born to parents of unknown blood type.

Methods

Blood samples were obtained from blood donors of the Animal Blood Bank (BSA-Banco de Sangue Animal). Blood typing was performed using a card method (RapidVet-H Feline Blood Typing; MDS).

Results

The studied population comprised 1070 purebred and non-purebred cats from Portugal and Spain aged between 1 and 8 years. Overall, frequencies of blood types A and B were 96.5% and 3.5%, respectively. No AB cats were found. Based on these data, the potential risks of NI and transfusion reactions in unmatched transfusions were calculated to be 6.8% and 2.8%, respectively.

Conclusions and relevance

Unlike previous studies, no type AB cats were found in this study. Although the calculated potential risks of transfusion reaction in unmatched transfusions and neonatal isoerythrolysis were low, blood typing prior to blood transfusion and blood typing of cats for breeding purposes are highly recommended.

Sistema de grupos sanguíneos AB em felídeos neotropicais e compatibilidade com gatos domésticos

RESUMO O principal sistema de grupos sanguíneos reconhecido para gatos é o AB. Os felinos apresentam anticorpos naturais contra o antígeno do tipo sanguíneo a que não pertencem, o que torna os testes de compatibilidade e as tipagens sanguíneas importantes na prevenção de reações transfusionais. O objetivo deste estudo foi realizar a tipagem sanguínea de oito gatos-mouriscos (Puma yagouaroundi), oito jaguatiricas (Leopardus pardalis), sete gatos-palheiros (Leopardus colocolo), sete gatos domésticos (Felis catus) da raça Persa e oito gatos domésticos sem raça definida (SRD), bem como realizar testes de compatibilidade entre os tipos sanguíneos iguais das diferentes espécies, para avaliar a possibilidade de transfusões interespecíficas. A técnica empregada para a tipagem foi a hemaglutinação em tubos de ensaio. A ocorrência do tipo sanguíneo tipo A foi de 100% entre as jaguatiricas, os gatos-palheiros e os gatos Persas e de 85,72% entre os gatos SRD. A ocorrência do tipo B foi de 100% nos gatos-mouriscos e de 14,28% nos gatos SRD. Considerando os testes de compatibilidade sanguínea, 87,5% (n=4) das jaguatiricas foram incompatíveis com os gatos domésticos, 100% (n= 6) dos gatos-palheiros foram compatíveis com os gatos domésticos e 100% (n= 4) dos gatos-mouriscos foram incompatíveis com os gatos domésticos do tipo B.

Molecular Characterization of the Cytidine Monophosphate-N-Acetylneuraminic Acid Hydroxylase (CMAH) Gene Associated with the Feline AB Blood Group System

Cat’s AB blood group system (blood types A, B, and AB) is of major importance in feline transfusion medicine. Type A and type B antigens are Neu5Gc and Neu5Ac, respectively, and the enzyme CMAH participating in the synthesis of Neu5Gc from Neu5Ac is associated with this cat blood group system. Rare type AB erythrocytes express both Neu5Gc and Neu5Ac. Cat serum contains naturally occurring antibodies against antigens occurring in the other blood types. To understand the molecular genetic basis of this blood group system, we investigated the distribution of AB blood group antigens, CMAH gene structure, mutation, diplotypes, and haplotypes of the cat CMAH genes. Blood-typing revealed that 734 of the cats analyzed type A (95.1%), 38 cats were type B (4.9%), and none were type AB. A family of three Ragdoll cats including two type AB cats and one type A was also used in this study. CMAH sequence analyses showed that the CMAH protein was generated from two mRNA isoforms differing in exon 1. Analyses of the nucleotide sequences of the 16 exons including the coding region of CMAH examined in the 34 type B cats and in the family of type AB cats carried the CMAH variants, and revealed multiple novel diplotypes comprising several polymorphisms. Haplotype inference, which was focused on non-synonymous SNPs revealed that eight haplotypes carried one to four mutations in CMAH, and all cats with type B (n = 34) and AB (n = 2) blood carried two alleles derived from the mutated CMAH gene. These results suggested that double haploids selected from multiple recessive alleles in the cat CMAH loci were highly associated with the expression of the Neu5Ac on erythrocyte membrane in types B and AB of the feline AB blood group system.

Survival Time of Cross-Match Incompatible Red Blood Cells in Adult Horses

Background

There is a markedly reduced half‐life of transfused RBCs when donor and recipient cats or humans are cross‐match incompatible. Only 10–20% of horses have naturally occurring alloantibodies. Therefore, cross‐match testing before blood transfusion is not always performed.

Hypothesis

Cross‐match incompatibility predicts shortened RBC survival time as compared to that of compatible or autologous blood.

Animals

Twenty healthy adult horses.

Methods

Prospective trial. Blood type, anti‐RBC antibody screen (before and 1 month after transfusion) and major and minor cross‐match determined 10 donor‐recipient pairs. Two pairs were cross‐match compatible, the remainder incompatible. Donor blood (4 L) was collected into citrate phosphate dextrose adenine‐1, labeled with NHS‐biotin, and transfused into recipients. Samples were collected at 1 hour and 1, 2, 3, 5, 7, 14, 21, 28, and 35 days after transfusion, and biotinylated RBCs were detected by flow cytometry. Horses were monitored for transfusion reaction during transfusion and daily for 5 days.

Results

Cross‐match incompatibility was significantly associated with decreased RBC survival time (P < .001). The half‐life of transfused incompatible (cross‐match >1+) allogenic equine RBCs was 4.7 (95% CI, 3.2–6.2) days versus 33.5 (24–43) days for compatible pairings. Cross‐match incompatibility was associated with acute febrile transfusion reaction (P = .0083). At day 30, only 1 horse had developed novel anti‐RBC antibodies.

Conclusions and Clinical Importance

Cross‐match incompatibility was predictive of febrile transfusion reaction and shortened transfused RBC survival, but did not result in production of anti‐RBC antibodies at 30 days. Cross‐match testing before transfusion is recommended.

Feline blood transfusions: A pinker shade of pale

PRACTICAL RELEVANCE

blood transfusions are a potentially life-saving procedure that are within the reach of most small animal practitioners. Only minimal equipment is required.

PATIENT GROUP

any cat with clinical signs attributable to a reduced red blood cell mass that is affecting oxygen transport (as a result of reduced packed cell volume or acute blood loss) is a potential candidate for a transfusion.

CLINICAL CHALLENGES

although the principles of transfusion medicine are not complicated, there can be fatal consequences if certain steps are omitted.

DIAGNOSTICS

blood typing kits and blood filters are readily available from veterinary wholesalers, laboratories and blood banking services.

EVIDENCE BASE

over the past three decades, a substantial body of clinical research and reports has built up covering feline blood types and transfusion medicine. This article draws on that research to provide clinical guidance aimed at all veterinarians in feline or small animal practice who either currently practise transfusion medicine or plan to do so.

Feline neonatal isoerythrolysis and the importance of feline blood types

Although feline neonatal isoerythrolysis is rare, associated mortality rate is high. It results from mating of type B blood queens with type A or AB blood toms. A comprehensive review on feline blood types and feline neonatal isoerythrolysis physiopathology, clinical features, diagnosis, treatment, and prevention is covered.

Frequencies of feline blood types at a referral hospital in the south east of England

OBJECTIVES

To determine the prevalence of blood types in the feline patients and blood donors of the Queen Mother Hospital for Animals (The Royal Veterinary College, London, UK), that were typed between 2000 and 2004.

METHODS

A retrospective study was performed using files of patients and blood donors of the Queen Mother Hospital for Animals seen between January 2000 and November 2004. Commercial blood typing cards were used to determine the blood type.

RESULTS

One hundred and fifty-six cats were included in the study; 51 (32.7 per cent) were pedigree and 105 (67.3 per cent) non-pedigree. Of the 51 pedigree cats, the prevalence of blood types was as follows: type A, 42 (82.4 per cent); type B, seven (13.7 per cent) and type AB, two (3.9 per cent). Of the 105 non-pedigree cats, the prevalence of blood types was as follows: type A, 71 (67.6 per cent); type B 32 (30.5 per cent) and type AB two (1.9 per cent).

CLINICAL SIGNIFICANCE

The prevalence of type B blood in non-pedigree cats is higher than previously suggested and shows high variability within the UK; because of this, blood typing all feline patients, not only the ones of a breed typically known to have higher prevalence of type B blood before transfusion, is absolutely necessary to avoid a fatal transfusion reaction.