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Niyibizi JB, Seifu D, Geurkink C, Formiller E, Muyombo T, Gashaija C, Uwayo HD, Uwizeyimana G, Gillard L. Assessment of Unexpected (Non-ABO) Red Blood Cell Antibodies and Their Associated Clinical Conditions Among Patients and Blood Donors Attending University Teaching Hospital of Kigali (CHUK) and Rwanda Blood Transfusion Division. Adv Hematol 2025; 2025:8871102. [PMID: 40151361 PMCID: PMC11944671 DOI: 10.1155/ah/8871102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 01/21/2025] [Accepted: 02/21/2025] [Indexed: 03/29/2025] Open
Abstract
Unexpected antibodies can cause hemolytic conditions. Therefore, screening for unexpected antibodies is essential for safe transfusion. The study was conducted at Rwanda Blood Transfusion Division and University Teaching Hospital of Kigali to assess unexpected antibodies with their associated clinical conditions. 8693 blood donors and 834 patients were screened for unexpected antibodies. Among 834 patients, 23 patients (2.75%) developed alloantibodies among which two of them had mixed alloantibodies. Five patients developed antibodies of uncertain specificities. Among 8693 blood donors, only 4 blood donors (0.046%) had clinically significant alloantibodies, whereas 6 blood donors (0.069%) had antibodies of uncertain specificities. Moreover, 3 patients (0.35%) had autoantibodies in their plasma. Different types of anemia were presented with patients who developed unexpected alloantibodies. History of transfusion and pregnancy were predictors of alloimmunization among patients (p < 0.01). Antibody screening and antibody identification are important for safe blood transfusion practices.
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Affiliation(s)
- Jean Baptiste Niyibizi
- School of Medicine, Basic Medical Sciences Division, University of Global Health Equity, Kigali, Rwanda
- College of Health Sciences, Specialist in Blood Bank (SBB) Program, Rush University, Chicago, Illinois, USA
| | - Daniel Seifu
- School of Medicine, Basic Medical Sciences Division, University of Global Health Equity, Kigali, Rwanda
| | - Chelsey Geurkink
- College of Health Sciences, Specialist in Blood Bank (SBB) Program, Rush University, Chicago, Illinois, USA
- Versiti Illinois Immunohematology Reference Laboratory, Aurora, Illinois, USA
| | - Erica Formiller
- College of Health Sciences, Specialist in Blood Bank (SBB) Program, Rush University, Chicago, Illinois, USA
| | - Thomas Muyombo
- Blood Transfusion Division (BTD), Rwanda Biomedical Center (RBC), Kigali, Rwanda
| | - Christopher Gashaija
- Blood Transfusion Division (BTD), Rwanda Biomedical Center (RBC), Kigali, Rwanda
| | - Henri Desire Uwayo
- Blood Transfusion Division (BTD), Rwanda Biomedical Center (RBC), Kigali, Rwanda
| | - Gilbert Uwizeyimana
- Department of Pathology, University Teaching Hospital of Kigali (CHUK), Kigali, Rwanda
| | - Laurie Gillard
- College of Health Sciences, Specialist in Blood Bank (SBB) Program, Rush University, Chicago, Illinois, USA
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Laureano M, Clarke G, Yan MTS. How do I provide rare red cells to patients? Transfusion 2023; 63:670-678. [PMID: 36310505 DOI: 10.1111/trf.17171] [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: 07/05/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 04/12/2023]
Abstract
BACKGROUND The demand for rare blood is expected to increase in Canada as its population continues to expand through immigration from diverse regions of the world. MATERIAL AND METHODS This paper outlines a national approach to providing rare red cells for patients through the Rare Blood Program of Canadian Blood Services (CBS). Data detailing the rare red cell requests and inventory managed by CBS' Rare Blood Program is provided. RESULTS The provision of rare red cells involves multiple considerations such as multidisciplinary communication, serologic/molecular confirmation, donor recruitment, inventory optimization and logistical factors. CONCLUSION The description of CBS' Rare Blood Program will inform others that seek to create, optimize, or expand programs that facilitate the provision of rare blood. New technologies such as next-generation sequencing may also affect how rare donors are identified and recruited in the future.
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Affiliation(s)
- Marissa Laureano
- Medical Affairs and Innovation, Canadian Blood Services, Ottawa, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Gwen Clarke
- Medical Affairs and Innovation, Canadian Blood Services, Ottawa, Ontario, Canada
- Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Matthew T S Yan
- Medical Affairs and Innovation, Canadian Blood Services, Ottawa, Ontario, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Affiliation(s)
- Jensyn K Cone Sullivan
- Department of Pathology, The Neely Cell Therapy Center, Tufts Medical Center, 800 Washington Street, #826, Boston, MA 02111, USA; Tufts University School of Medicine, Boston, MA, USA
| | - Nicholas Gleadall
- Department of Haematology, University of Cambridge, University of Cambridge Biomedical Campus, Long Road, Cambridge, CB2 0PT, UK
| | - William J Lane
- Department of Pathology, Brigham and Women's Hospital, Hale Building for Transformative Medicine, Room 8002L, 60 Fenwood Road, Boston, MA 02115, USA; Harvard Medical School, Boston, MA, USA.
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Abstract
Red blood cell (RBC) transfusion is one of the most frequently performed clinical procedures and therapies to improve tissue oxygen delivery in hospitalized patients worldwide. Generally, the cross-match is the mandatory test in place to meet the clinical needs of RBC transfusion by examining donor-recipient compatibility with antigens and antibodies of blood groups. Blood groups are usually an individual's combination of antigens on the surface of RBCs, typically of the ABO blood group system and the RH blood group system. Accurate and reliable blood group typing is critical before blood transfusion. Serological testing is the routine method for blood group typing based on hemagglutination reactions with RBC antigens against specific antibodies. Nevertheless, emerging technologies for blood group testing may be alternative and supplemental approaches when serological methods cannot determine blood groups. Moreover, some new technologies, such as the evolving applications of blood group genotyping, can precisely identify variant antigens for clinical significance. Therefore, this review mainly presents a clinical overview and perspective of emerging technologies in blood group testing based on the literature. Collectively, this may highlight the most promising strategies and promote blood group typing development to ensure blood transfusion safety.
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Affiliation(s)
- Hong-Yang Li
- Department of Blood Transfusion, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Kai Guo
- Department of Transfusion Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- *Correspondence: Kai Guo
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Next-generation sequencing of 35 RHD variants in 16 253 serologically D- pregnant women in the Finnish population. Blood Adv 2021; 4:4994-5001. [PMID: 33057632 DOI: 10.1182/bloodadvances.2020001569] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 08/11/2020] [Indexed: 12/17/2022] Open
Abstract
Fetal RHD screening for targeted routine antenatal anti-D prophylaxis has been implemented in many countries, including Finland, since the 2010s. Comprehensive knowledge of the RHD polymorphism in the population is essential for the performance and safety of the anti-D prophylaxis program. During the first 3 years of the national screening program in Finland, over 16 000 samples from RhD- women were screened for fetal RHD; among them, 79 samples (0.5%) containing a maternal variant allele were detected. Of the detected maternal variants, 35 cases remained inconclusive using the traditional genotyping methods and required further analysis by next-generation sequencing (NGS) of the whole RHD gene to uncover the variant allele. In addition to the 13 RHD variants that have been previously reported in different populations, 8 novel variants were also detected, indicating that there is more variation of RHD in the RhD- Finnish population than has been previously known. Three of the novel alleles were identified in multiple samples; thus, they are likely specific to the original Finnish population. National screening has thus provided new information about the diversity of RHD variants in the Finnish population. The results show that NGS is a powerful method for genotyping the highly polymorphic RHD gene compared with traditional methods that rely on the detection of specific nucleotides by polymerase chain reaction amplification.
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Abstract
Genomics is affecting all areas of medicine. In transfusion medicine, DNA-based genotyping is being used as an alternative to serological antibody-based methods to determine blood groups for matching donor to recipient. Most antigenic polymorphisms are due to single nucleotide polymorphism changes in the respective genes, and DNA arrays that target these changes have been validated by comparison with antibody-based typing. Importantly, the ability to test for antigens for which there are no serologic reagents is a major medical advance to identify antibodies and find compatible donor units, and can be life-saving. This review summarizes the evolving use and applications of genotyping for red cell and platelet blood group antigens affecting several areas of medicine. These include prenatal medicine for evaluating risk of fetal or neonatal disease and candidates for Rh-immune globulin; transplantation for bone marrow donor selection and transfusion support for highly alloimmunized patients and for confirmation of A2 status of kidney donors; hematology for comprehensive typing for patients with anemia requiring chronic transfusion; and oncology for patients receiving monoclonal antibody therapies that interfere with pretransfusion testing. A genomics approach allows, for the first time, the ability to routinely select donor units antigen matched to recipients for more than ABO/RhD to reduce complications. Of relevance, the growth of whole-genome sequencing in chronic disease and for general health will provide patients' comprehensive extended blood group profile as part of their medical record to be used to inform selection of the optimal transfusion therapy.
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Hyland CA, Roulis EV, Schoeman EM. Developments beyond blood group serology in the genomics era. Br J Haematol 2019; 184:897-911. [PMID: 30706459 DOI: 10.1111/bjh.15747] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Blood group serology and single nucleotide polymorphism-based genotyping platforms are accurate but do not provide a comprehensive cover for all 36 blood group systems and do not cover the antigen diversity observed among population groups. This review examines the extent to which genomics is shaping blood group serology. Resources for genomics include the Human Reference Genome Sequence assembly; curated blood group tables listing variants; public databases providing information on genetic variants from world-wide studies; and massively parallel sequencing technologies. Blood group genomic studies span the spectrum, from bioinformatic data mining of huge data sets containing whole genome and whole exome information to laboratory investigations utilising targeted sequencing approaches. Blood group predictions based on genome sequencing and genomic studies are proving accurate, and have shown utility in both research and reference settings. Overall, studies confirm the potential for blood group genomics to reshape donor and patient transfusion management strategies to provide more compatible blood transfusions.
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Affiliation(s)
- Catherine A Hyland
- Clinical Services and Research, Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia
| | - Eileen V Roulis
- Clinical Services and Research, Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia
| | - Elizna M Schoeman
- Clinical Services and Research, Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia
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