1
|
Al-Riyami AZ, Al Hinai D, Al-Rawahi M, Al-Hosni S, Al-Zadjali S, Al-Marhoobi A, Al-Khabori M, Al-Riyami H, Denomme GA. Molecular blood group screening in Omani blood donors. Vox Sang 2021; 117:424-430. [PMID: 34647328 DOI: 10.1111/vox.13204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/24/2021] [Accepted: 08/29/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Blood group genotyping has been used in different populations. This study aims at evaluating the genotypes of common blood group antigens in the Omani blood donors and to assess the concordance rate with obtained phenotypes. MATERIAL AND METHODS Blood samples from 180 Omani donors were evaluated. Samples were typed by serological methods for the five blood group systems MNS, RH (RHD/RHCE), KEL, FY and JK. Samples were genotyped using RBC-FluoGene vERYfy eXtend kit (inno-train©). Predicted phenotypic variants for 70 red blood cell antigens among the MNS, RH (RHD/RHCE), KEL, FY, JK, DO, LU, YT, DI, VEL, CO and KN blood group systems were assessed. RESULTS Simultaneous phenotype and genotype results were available in 130 subjects. Concordance rate was >95% in all blood group systems with exception of Fy(b+) (87%). Homozygous GATA-1 mutation leading to erythroid silencing FY*02N.01 (resulting in the Fy(b-)ES phenotype) was detected in 81/112 (72%) of genotyped samples. In addition, discrepant Fyb phenotype/genotype result was obtained in 14/112 samples; 13 of which has a heterozygous GATA-1 mutation and one sample with a wild GATA genotype. D and partial e c.733C>G variants expressing the V+VS+ phenotype were found in 22/121 (18.2%) and 14/120 (11.7%) of the samples, respectively. Di(a-b+), Js(a-b+), Yt(a+b-) and Kn(a+b-) genotype frequencies were 99.4%, 95.8%, 91.9% and 97.7%, respectively. CONCLUSION In conclusion, we report a high frequency of FY*02N.01 allele due to homozygous c.-67T>C GATA-1 single-nucleotide variation. This is the first study reporting the detailed distribution of common and rare red cell genotypes in Omani blood donors.
Collapse
Affiliation(s)
- Arwa Z Al-Riyami
- Department of Haematology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Dina Al Hinai
- College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Mohammed Al-Rawahi
- Department of Haematology, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Saif Al-Hosni
- Department of Haematology, Sultan Qaboos University Hospital, Muscat, Oman
| | | | - Ali Al-Marhoobi
- Department of Haematology, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Murtadha Al-Khabori
- Department of Haematology, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Hamad Al-Riyami
- Department of Genetics, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Gregory A Denomme
- Diagnostic Laboratories, Versiti Blood Center of Wisconsin, Milwaukee, Wisconsin, USA
| |
Collapse
|
2
|
Successful prenatal management of two foetuses affected by antibodies against GP.Mur with prenatal genotyping analysis and a literature review. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2020; 19:135-143. [PMID: 33085590 DOI: 10.2450/2020.0058-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 06/30/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND GP.Mur belongs to the GP(B-A-B) hybrid glycophorin family, which is the most common hybrid glycophorin in Southeast Asia. Antibodies against GP.Mur may cause a clinically significant haemolytic disease of the foetus and newborn (HDFN) although, so far, not many cases have been reported in mainland China. MATERIALS AND METHODS Two Chinese women with a history of severe hydrops foetalis were seen in our centre. Alloantibody identification and GYP.Mur genotyping analysis were used for prenatal evaluation. Intrauterine transfusion was performed in two pregnancies in case 1. The features of these two women are described and literature-reported cases of HDFN related to antibodies against GP.Mur are summarised. RESULTS The phenotype of both mothers was Mia- Mur-, while the fathers' was Mia+ Mur+ with a heterozygous GYP.Mur hybrid gene as determined by a high-resolution melting method of genotyping. In case 1, the antibodies against GP.Mur were detected in the mother's serum and the cord blood of two foetuses. Fortunately, the latest foetus was successfully saved after intrauterine transfusion. In case 2, hydrops foetalis occurred in the first two pregnancies, but the risk of HDFN was excluded for the third foetus because of the GP.Mur negative phenotype. The literature review showed that 68.8% (11/16) of the reported cases of HDFN related to antibodies against GP.Mur occurred in the Chinese population, and that 37.5% (6/16) of them were cases of severe HDFN. DISCUSSION More cases of severe HDFN caused by antibodies against GP.Mur are presumably undetected as GP.Mur cells are not included in the panel of obligatory screening tests in most Southeast Asian countries including mainland China. The high-resolution melting method for GYP.Mur genotyping and zygosity detection is helpful in prenatal management.
Collapse
|
3
|
Park JH, Han JH, Park G. Rapid and Reliable One-Step ABO Genotyping Using Direct Real-Time Allele-Specific PCR and Melting Curve Analysis Without DNA Preparation. Indian J Hematol Blood Transfus 2019; 35:531-537. [PMID: 31388269 DOI: 10.1007/s12288-018-1053-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 11/24/2018] [Indexed: 11/26/2022] Open
Abstract
ABO genotyping is a molecular diagnostic technique important for transfusion and transplantation in medicine, and human identification in forensic science. Because ABO genotyping are labor intensive and time consuming, the genotyping cannot be firstly used to resolve the serological ABO discrepancy in blood bank. For rapid one-step ABO genotyping, we developed direct, real-time, allele-specific polymerase chain reaction (PCR), and melting curve analysis (DRAM assay) without DNA preparation. In DRAM assay, we used a special PCR buffer for direct PCR, a rapid RBC lysis buffer, white blood cells as template without DNA preparation, allele-specific primers for discriminating three ABO alleles (261G/del, 796C/A, and 803G/C), and melting curve analysis as a detection method. There was 100% concordance among the results of ABO genotyping by the DRAM assay, serologic typing, PCR-RFLP and PCR-direct sequencing of 96 venous blood samples. We were able to reduce the number of manual steps to three and the hands-on time to 12 min, compared to seven steps and approximately 40 min for conventional ABO genotyping using allele-specific PCR with purified DNA and agarose gel electrophoresis. We have established and validated the DRAM assay for rapid and reliable one-step ABO genotyping in a closed system. The DRAM assay with an appropriate number of allele-specific primers could help in resolving ABO discrepancies and should be valuable in clinical laboratory and blood bank.
Collapse
Affiliation(s)
- Jun-Hee Park
- 1Department of Otolaryngology-Head and Neck Surgery, Chosun University College of Medicine, 365 Pilmun-daero, Dong-gu, Gwangju, 61453 South Korea
| | - Ji-Hye Han
- 1Department of Otolaryngology-Head and Neck Surgery, Chosun University College of Medicine, 365 Pilmun-daero, Dong-gu, Gwangju, 61453 South Korea
| | - Geon Park
- 2Department of Laboratory Medicine, Chosun University College of Medicine, 365 Pilmun-daero, Dong-gu, Gwangju, 61453 South Korea
| |
Collapse
|
4
|
Cruz BR, de Souza Silva TC, de Souza Castro B, Chiba AK, Moritz E, Braga JP, Figueiredo MS, Bordin JO. Molecular matching for patients with haematological diseases expressing altered RHD-RHCE genotypes. Vox Sang 2019; 114:605-615. [PMID: 31087345 DOI: 10.1111/vox.12789] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 04/03/2019] [Accepted: 04/17/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND OBJECTIVES The high homology and the inverted orientation of RHD and RHCE may give rise to non-functional and aberrant RH alleles. RH genotyping is used to screen RH matched donors to African descent patients. This study aimed to define a strategy for testing RHD and RHCE variants in blood donors to provide compatible units for transfusion of patients with haematological diseases. MATERIALS AND METHODS Samples from 132 patients [101 Sickle cell disease (SCD), 14 myelodysplastic syndrome (MDS), 17 acute myelogenous leukaemia (AML)] and 198 Brazilian donors were studied. Major blood group alleles, RHD, RHCE alleles and RHD zygosity were determined by the blood-MLPA assay. Sequencing was performed to determine RHD and RHCE variant subtypes. A match was an RH genotype that did not encode Rh antigens absent in the patient, along with matching for ABO, MNS, KEL, FY, JK and DI antigens. RESULTS Overall, 7·6% of blood donors and 17.4% of patients presented RH genotypes that predict expression of partial Rh antigens or lack of high prevalence Rh antigens. From 23 patients with clinically relevant RH genotypes, 15 had available matched donors. CONCLUSION We report the presence of clinically relevant RH genotypes in SCD and in non-SCD patients. In our admixed population, many patients carry variant RHCE alleles in heterozygosity with normal RHCE alleles. Thus, our results suggest that donors could be selected based on the normal RH allele.
Collapse
Affiliation(s)
- Bruno Ribeiro Cruz
- Department of Clinical and Experimental Oncology, Escola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, Brazil
| | - Thamy Caroline de Souza Silva
- Department of Clinical and Experimental Oncology, Escola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, Brazil
| | - Bianca de Souza Castro
- Department of Clinical and Experimental Oncology, Escola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, Brazil
| | - Akemi Kuroda Chiba
- Department of Clinical and Experimental Oncology, Escola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, Brazil
| | - Elyse Moritz
- Department of Clinical and Experimental Oncology, Escola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, Brazil
| | - Josefina Pellegrini Braga
- Department of Pediatrics, Escola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, Brazil
| | - Maria Stella Figueiredo
- Department of Clinical and Experimental Oncology, Escola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, Brazil
| | - José O Bordin
- Department of Clinical and Experimental Oncology, Escola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, Brazil
| |
Collapse
|
5
|
Wei L, Lopez GH, Zhang Y, Wen J, Wang Z, Fu Y, Hyland CA, Flower RL, Luo G, Ji Y. Genotyping analysis of MNS blood group GP(B‐A‐B) hybrid glycophorins in the Chinese Southern Han population using a high‐resolution melting assay. Transfusion 2018; 58:1763-1771. [DOI: 10.1111/trf.14641] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 01/30/2018] [Accepted: 02/11/2018] [Indexed: 01/03/2023]
Affiliation(s)
- Ling Wei
- Institute of Clinical Blood Transfusion, Guangzhou Blood CenterGuangzhou P.R. China
| | - Genghis H. Lopez
- Clinical Services and Research, Australian Red Cross Blood ServiceQueensland Australia
| | - Yang Zhang
- Institute of Clinical Blood Transfusion, Guangzhou Blood CenterGuangzhou P.R. China
| | - Jizhi Wen
- Institute of Clinical Blood Transfusion, Guangzhou Blood CenterGuangzhou P.R. China
| | - Zhen Wang
- Institute of Clinical Blood Transfusion, Guangzhou Blood CenterGuangzhou P.R. China
| | - Yongshui Fu
- Institute of Clinical Blood Transfusion, Guangzhou Blood CenterGuangzhou P.R. China
| | - Catherine A. Hyland
- Clinical Services and Research, Australian Red Cross Blood ServiceQueensland Australia
| | - Robert L. Flower
- Clinical Services and Research, Australian Red Cross Blood ServiceQueensland Australia
| | - Guangping Luo
- Institute of Clinical Blood Transfusion, Guangzhou Blood CenterGuangzhou P.R. China
| | - Yanli Ji
- Institute of Clinical Blood Transfusion, Guangzhou Blood CenterGuangzhou P.R. China
| |
Collapse
|
6
|
Kim B, Lee ST, Kim S, Choi JR, Kim HO. Application of Multiplex Ligation-Dependent Probe Amplification Assay for Genotyping Major Blood Group Systems Including DEL Variants in the D-Negative Korean Population. Ann Lab Med 2018; 38:32-38. [PMID: 29071816 PMCID: PMC5700144 DOI: 10.3343/alm.2018.38.1.32] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 05/02/2017] [Accepted: 08/31/2017] [Indexed: 01/22/2023] Open
Abstract
Background The DEL blood type, a very weak D variant, is a major concern in the field of transfusion medicine because of its potential to cause anti-D alloimmunization. We investigated the molecular basis of serologically D-negative phenotypes, including the DEL type, and the distribution of other blood group systems in the Korean population using the recently developed multiplex ligation-dependent probe amplification (MLPA) assay. Methods Blood group genotyping using the MLPA assay and RhCE phenotyping were performed on randomly selected 95 D-negative red blood cell products. The MLPA results were verified by multiplex PCR for the RHD promoter, exons 4, 7, and 10 and by direct sequencing of RHD exon 9. Results Out of 95 cases, total deletion of the RHD was observed in 74 cases (77.9%) and four cases (4.2%) had an RHD-CE-D hybrid allele. The other 17 cases (17.9%) had an RHD(1227G>A) allele, which was further confirmed by sequencing analysis. The RhCE phenotypes of RHD(1227G>A) alleles were composed of 14 Cce and 3 CcEe, and all 60 cases of the ce phenotype were revealed to have a total deletion of the RHD. Genotyping results and allele distribution of the other 17 blood group systems were consistent with previous reports on the East Asian population. Conclusions MLPA assay correctly determined RHD genotype, including RHD-CE-D hybrid alleles or RHD(1227G>A) allele, and other clinically relevant blood group genotypes in D-negative Koreans. The use of MLPA assay on serologically D-negative individuals may help improve transfusion safety by preventing anti-D alloimmunization.
Collapse
Affiliation(s)
- Banseok Kim
- Department of Laboratory Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Seung Tae Lee
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sinyoung Kim
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea.
| | - Jong Rak Choi
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun Ok Kim
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| |
Collapse
|
7
|
Denomme GA, Anani WQ, Avent ND, Bein G, Briggs LB, Lapadat RC, Montemayor C, Rios M, St-Louis M, Uhl L, Wendel S, Flegel WA. Red cell genotyping precision medicine: a conference summary. Ther Adv Hematol 2017; 8:277-291. [PMID: 29051799 DOI: 10.1177/2040620717729128] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This review summarizes the salient points of the symposium 'Red Cell Genotyping 2015: Precision Medicine' held on 10 September 2015 in the Masur Auditorium of the National Institutes of Health. The specific aims of this 6th annual symposium were to: (1) discuss how advances in molecular immunohematology are changing patient care; (2) exemplify patient care strategies by case reports (clinical vignettes); (3) review the basic molecular studies and their current implications in clinical practice; (4) identify red cell genotyping strategies to prevent alloimmunization; and (5) compare and contrast future options of red cell genotyping in precision transfusion medicine. This symposium summary captured the state of the art of red cell genotyping and its contribution to the practice of precision medicine.
Collapse
Affiliation(s)
- Gregory A Denomme
- Diagnostic Laboratories, BloodCenter of Wisconsin, 638 N 18th Street, PO Box 2178, Milwaukee, WI 53201-2178, USA
| | - Waseem Q Anani
- Medical Sciences Institute, BloodCenter of Wisconsin, Milwaukee, WI, USA
| | | | | | - Lynne B Briggs
- Information Services Versiti/BloodCenter of Wisconsin, Milwaukee, WI, USA
| | - Razvan C Lapadat
- Medical Sciences Institute, BloodCenter of Wisconsin, Milwaukee, WI, USA
| | - Celina Montemayor
- Department of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Maria Rios
- Office of Blood Research and Review, CBER/FDA, Rockville, MD, USA
| | | | - Lynne Uhl
- Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | | | - Willy A Flegel
- Department of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, MD, USA
| |
Collapse
|
8
|
Genotyping for Glycophorin GYP(B-A-B) Hybrid Genes Using a Single Nucleotide Polymorphism-Based Algorithm by Matrix-Assisted Laser Desorption/Ionisation, Time-of-Flight Mass Spectrometry. Mol Biotechnol 2017; 58:665-671. [PMID: 27435823 DOI: 10.1007/s12033-016-9966-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The genetic basis for five GP(B-A-B) MNS system hybrid glycophorin blood group antigens results from rearrangement between the homologous GYPA and GYPB genes. Each hybrid glycophorin displays a characteristic profile of antigens. Currently, no commercial serological reagents are currently available to serologically type for these antigens. The aim of this study was to develop a single nucleotide polymorphism (SNP) mapping genotyping technique to allow characterisation of various GYP(B-A-B) hybrid alleles. Matrix-assisted laser desorption/ionisation time-of-flight (MALDI-TOF) mass spectrometry (MS) assays were designed to genotype five GYP(B-A-B) hybrid alleles. Eight nucleotide positions were targeted and incorporated into the SNP mapping protocol. The allelic frequencies were calculated using peak areas. Sanger sequencing was performed to resolve a GYP*Hop 3' breakpoint. Observed allelic peak area ratios either coincided with the expected ratio or were skewed (above or below) from the expected ratio with switching occurring at and after the expected break point to generate characteristic mass spectral plots for each hybrid. Sequencing showed that the GYP*Hop crossover in the intron 3 region, for this example, was identical to that for GYP*Bun reference sequence. An analytical algorithm using MALDI-TOF MS genotyping platform defined GYPA inserts for five GYP(B-A-B) hybrids. The SNP mapping technique described here demonstrates proof of concept that this technology is viable for genotyping hybrid glycophorins, GYP(A-B-A), GYP(A-B) and GYP(B-A), and addresses the gap in current typing technologies.
Collapse
|
9
|
Performance evaluation study of ID CORE XT, a high throughput blood group genotyping platform. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2016; 16:193-199. [PMID: 27893355 DOI: 10.2450/2016.0146-16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 09/05/2016] [Indexed: 12/24/2022]
Abstract
BACKGROUND Traditionally, red blood cell antigens have been identified using serological methods, but recent advances in molecular biology have made the implementation of methods for genetic testing of most blood group antigens possible. The goal of this study was to validate the performance of the ID CORE XT blood group typing assay. MATERIALS AND METHODS One thousand independent samples from donors, patients and neonates were collected from three research institutes in Spain and the Netherlands. DNA was extracted from EDTA-anticoagulated blood. The data were processed with the ID CORE XT to obtain the genotypes and the predicted blood group phenotypes, and results were compared to those obtained with well-established serological and molecular methods. All 1,000 samples were typed for major blood group antigens (C, c, E, e, K) and 371-830 samples were typed for other antigens depending on the rarity and availability of serology comparators. RESULTS The incorrect call rate was 0%. Four "no calls" (rate: 0.014%) were resolved after repetition. The sensitivity of ID CORE XT for all phenotypes was 100% regarding serology. There was one discrepancy in E- antigen and 33 discrepancies in Fyb- antigen. After bidirectional sequencing, all discrepancies were resolved in favour of ID CORE XT (100% specificity). ID CORE XT detected infrequent antigens of Caucasians in the sample as well as rare allelic variants. DISCUSSION In this evaluation performed in an extensive sample following the European Directive, the ID CORE XT blood genotyping assay performed as a reliable and accurate method for correctly predicting the genotype and phenotype of clinically relevant blood group antigens.
Collapse
|
10
|
Abstract
Traditional serological methods, which have been used for decades to evaluate the human erythrocyte antigen (HEA) composition of recipient and donor specimens, have some serious limitations. Specific reagent antisera are not available for all clinically relevant antigens (eg, V antigen). Reagent antisera are expensive, and serological testing is labor intensive. The results of serological testing are subjective and semiquantitative (eg, microscopic, weak, 1+, 2+, 3+, 4+), and may vary from one technologist to another. Further, in many clinical situations, serological testing may be difficult or impossible.Recent developments in nucleic acid-based testing (molecular diagnostics) have made it possible to genotype HEA in the clinical laboratory. Most allelic variations occur due to single nucleotide polymorphisms (SNPs), which can be detected and from which the phenotypes can be predicted. HEA genotyping offers several technical and clinical advantages compared with serological testing. The Immucor PreciseType HEA Test is the first and currently the only platform for clinical testing approved by the United States Food and Drug Administration (FDA), to our knowledge.
Collapse
Affiliation(s)
- David S Wilkinson
- Transfusion Medicine Service, Division of Clinical Pathology, Department of Pathology, Virginia Commonwealth University School of Medicine, Richmond, VA
| |
Collapse
|
11
|
Flegel WA, Gottschall JL, Denomme GA. Implementing mass-scale red cell genotyping at a blood center. Transfusion 2015; 55:2610-5; quiz 2609. [PMID: 26094790 DOI: 10.1111/trf.13168] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 04/14/2015] [Accepted: 04/15/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND When problems with compatibility beyond ABO and D arise, currently transfusion services search their inventories and perform time-consuming serologic testing to locate antigen-negative blood. These clinically important blood group antigens can be detected reliably by red cell genotyping, which is a technology whereby DNA-based techniques are used to evaluate gene polymorphisms that determine the expression of blood group antigens. We introduced mass-scale genotyping and measured availability of genotyped blood. STUDY DESIGN AND METHODS All non-Caucasian donors qualified for genotyping along with donors who had a history of repeat donation. Mass-scale red cell genotyping, performed on an electronic interfaced open array platform, was implemented to screen blood donors for 32 single-nucleotide polymorphisms that predicted 42 blood group antigens. Genotype screening results were confirmed by phenotyping, when needed for antigen-negative transfusion, before release of the red blood cell (RBC) unit. RESULTS Approximately 22,000 donors were red cell genotyped within 4 months and a total of 43,066 donors in 4 years. There were 463 discordances (0.52% of 89,596 genotypes with a phenotype). Among the 307 resolved discordances, approximate equal numbers represented historical serologic or genotyping discrepancies (n = 151 and n = 156, respectively). In the final year of the study, a mean of 29% of the daily inventory had a genotype. CONCLUSIONS Red cell genotyping of blood donors using an electronic interface created a large and stable supply of RBC units with historical genotypes. The database served the needs of antigen-negative blood requests for a large regional blood center and allowed us to abandon screening by serology.
Collapse
Affiliation(s)
- Willy A Flegel
- Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland
| | - Jerome L Gottschall
- Department of Pathology, Medical College of Wisconsin.,Diagnostic Laboratories, BloodCenter of Wisconsin, Milwaukee, Wisconsin
| | - Gregory A Denomme
- Diagnostic Laboratories, BloodCenter of Wisconsin, Milwaukee, Wisconsin
| |
Collapse
|