Prevalence of Principal Rh Blood Group Antigens in Blood Donors at the Blood Bank of a Tertiary Care Hospital in Southern India

Frequency of ABO and Rh Blood Groups Among Blood Donors in the Hail Region of Saudi Arabia

OBJECTIVE

Proper blood bank inventory management and safe, efficient blood transfusion services require a thorough understanding of ABO and Rh(D) blood group distributions in specific populations. The objective of this research was to evaluate the distribution of ABO and Rh blood types among different ethnic blood donors in the Hail region of Saudi Arabia and compare the results to those of other populations.

METHODOLOGY

Data from 3,166 blood donors were analyzed retrospectively. Blood bank records provided sociodemographic information as well as blood group phenotypes. Descriptive statistics were employed. The distribution of ABO and Rh blood types was statistically examined using the chi-square test.

RESULTS

The study identified a total of 3,166 blood donors, with the majority being males (3,083 (97.4%)). The median age of the donors was 35 years, with an interquartile range of 30-41 years. Of the cohort, 1,425 (45%) consisted of young donors, defined as individuals aged 30-41 years. The O blood type accounted for 1,409 (44.5%) of all types, making it the most prevalent. The next most common blood types were B at 837 (26.4%), A at 741 (23.4%), and AB at 179 (5.7%). When combined, O positive was the most prevalent type, accounting for 1,226 (38.7%) of the total. This was followed by type B positive at 745 (23.5%), type A positive at 651 (20.6%), O negative at 183 (5.8%), AB positive at 171 (5.3%), B negative at 92 (2.9%), A negative at 90 (2.8%), and AB negative at eight (0.3%).

CONCLUSION

According to the results, out of all the ABO phenotypes, O was the most common. B, A, and AB came next. In addition, Rh(D) positivity was observed in 88.2% of the donors. These results have considerable consequences for blood transfusion strategies in the Hail region.

The Distribution Patterns of Rhesus (Rh) Antigens

INTRODUCTION

The determination of one's blood group is dictated by the inheritance-based diversity in the presence or absence of RBC antigens on the surface. Extended Rhesus (Rh) antigens are the most clinically relevant antigens of blood group systems after the ABO blood group system in transfusion medicine. The aim of this study was to serologically assess the prevalence of extended Rh antigens across diverse blood group systems.

METHODS

A total of 2043 samples were tested for the ABO blood group and Rh typing with monoclonal antisera. The Rh phenotyping (C, c, E, e ) was performed on all the samples.

RESULTS

The most frequently observed ABO blood group was O (36.5%), while AB (13.6%) was identified as the least prevalent. Positive Rh D antigen was found in 91.6% of tested samples, while 8.4% were Rh D-negative. The most frequently encountered antigen was e, followed by D, while the least prevalent was E.

DISCUSSION

Establishing a Rh phenotype repository for blood donors and conducting Rh phenotype assessments as part of pretransfusion testing before initiating the initial blood transfusion for each patient could significantly lower the patients' incidence of alloimmunization.

Variable reactivity of Rh D antigen and its serological characterization

Background: Variation in the reactivity on Rh D typing may pose challenges in interpretation and ambiguity in further patient management.Materials and Methods: A prospective study was conducted in the department of transfusion medicine for a period of 18 months. Blood grouping was performed by fully automated equipment employing column agglutination technique. All the samples with Rh D negative or discrepant reactions were subjected to weak D testing by the antihuman globulin testing method. Samples that tested positive were categorized as serological weak D type or Variant D and were further phenotyped with Partial D typing set with 6 monoclonal anti D antisera.Results: A total of 82,824 samples were tested for Rh D type during the study period. Of the study population, 65.7% were males. On Rh D type majority were Rh D positive (93%), 6.9% were negative, and the result was discrepant in 0.1% (70) samples. The overall prevalence of variant D was 1.28% (75) of the Rh D negative population and 0.09% of the total study population. The detection rate of variant D phenotype was significantly higher by the Column agglutination technique. Upon testing with Partial D kit, the partial D variant in the majority reacted wil all the 6 antisera and hence we could not rule out DIII(60%), in rest it was inconclusive. In 43% of subjects with Rh D discrepancy 'C' antigen was found in a homozygous state.Conclusion: The introduction of partial D typing kit alone may not help in the absolute characterization of variant D. Extended serological testing and selective integration of molecular testing is the need of the hour.

ABO, Rh, and kell blood group antigen frequencies in blood donors at the tertiary care hospital of Northwestern India

BACKGROUND:

This study was performed to provide information on frequencies of ABO, Rh & Kell antigens/alleles, phenotype in blood donors at Blood Bank, SMS hospital, Jaipur and to compare them with other races.

METHODOLOGY:

This study was conducted on blood donors from April 2016 to March 2017 using a fully automated system for ABO,Rh & Kell typing of blood cells. D, C, c, E, e & K antigens were typed using monoclonal antisera from Immucor The data were collected and calculations done to determine the antigen/allele, phenotype. The chi square test 3 degree of freedom with P < 0.001 (S) was used for comparisons between the results of our study and those of other studies.

RESULTS:

A total of 8067 donors were included in this study. Maximum donors was of B blood group (39.4%) of age 18-25(35.5%) with 60-69kg weight (65%). The most common Rh antigen found was e(99.3%) followed by D (93.8%), C (85.4%), c (60.1%), E (17.5%). R1r (DCCee) was the most common phenotype in our study (39.5%). Kell (K+) antigen was present in 2.7% of donors.

CONCLUSION:

We have determined the prevalence of Rh antigens and Rh phenotypes in blood donor at our hospital and derived the allele frequencies in the same population.

Retrospective study of frequency of ABO and Rhesus blood group among population of Safdarabad and Faisalabad cities of Pakistan

Objective

The current study aimed to investigate the ABO and rhesus (Rh) blood group frequency in the people of District Faisalabad and Sheikhupura, Punjab Province, Pakistan. The retrospective study was conducted on more than thirty thousand people including both male and female patients admitted to the Tehsil Headquarter Hospital, Safdarabad and The Best Hospital, Faisalabad. Blood samples were taken from each subject and subsequently ABO and Rh blood groups were evaluated separately. The antigen antibody agglutination slide test for blood grouping (ABO) and Rh were used to assess the blood group frequencies.

Results

The frequencies of ABO blood group distribution indicated that blood group B was predominant in the people of Safdarabad followed by O, A and AB respectively. While, among people of Faisalabad, blood group O was predominant followed B, A and AB respectively. Rh negative phenotype was found lesser distributed as compared to the positive Rh phenotype.

Patient blood management in a patient with multiple red cell antibodies (anti-C, anti-e, and anti-K) undergoing liver transplant in South India: A team approach

End-stage liver disease (ESLD) patients undergoing liver transplant (LT) surgery are often multiply alloimmunized and pose significant challenges to the transfusion services in terms of red cell cross-match incompatibility, unpredictable blood requirements, and often lead to significant delays in availing compatible red cell units. We report a case of a 64-year-old female from Bahrain, a known case of hepatitis C-related ESLD referred for LT surgery. She had a history of multiple uneventful transfusions in the preceding year. Her blood group was A-positive, direct antiglobulin test, and cold antibodies were negative. Indirect antiglobulin test was positive, and antibody identification confirmed the presence of anti-C, anti-e, and anti-K. Her red cell phenotype was R₂R₂ and Kell negative (C-c+E+e-K-). The patient was started on erythropoietin. Requests for R₂R₂ and Kell negative units were sent to various blood banks across the country. After >800 A/O group units phenotyping and a waiting period of 6 weeks, two compatible R₂R₂ phenotypes and Kell negative could be arranged in-house and three units were received from Gurgaon, North India. Intraoperative management included blood preservation techniques including cell salvage, antifibrinolytic drug, and monitoring using thromboelastography. The estimated blood loss was 350 ml with pre- and postoperative Hb 10.4 gm% and 9.2 gm%, respectively. She received intraoperatively two units of single-donor platelet and four units of fresh frozen plasma and postoperatively one unit of leukocyte-depleted-packed red cells and doing well at 12-month follow-up. This case highlights the importance of advance immunohematology for timely detection of alloimmunization and providing antigen-negative compatible units, proper communication between the transfusion specialists, and the clinical team for proper patient blood management as well as the need for central rare donor registry program to avoid delays in providing compatible blood in such inevitable cases.

Red cell antigen phenotypes in blood donors & thalassaemia patients for creation of red cell antigen-matched inventory

Background & objectives:

Patients with thalasssaemia are at a risk of alloimmunization and the presence of RBC alloantibodies further complicates transfusion therapy. Matching for the critical antigens of Rh, Kell, Kidd and Duffy blood group systems has been shown to minimize alloimmunization. The aim of the present study was to create a database of extensively typed donors for clinically significant and common blood group antigens of Rh, Kidd, Kell and Duffy systems for transfusion therapy of multitransfused thalassaemic patients.

Methods:

Five hundred O group regular blood donors were phenotyped for Rh, Kell, Duffy and Kidd blood group antigens using haemagglutination technique. Eighty four non-alloimmunized and 15 alloimmunized thalassaemia major patients with known antigenic profiles (determined by polymerase chain reaction with sequence-specific primers) were selected for this study.

Results:

By analyzing antigen profiles of 500 O group regular donors, a database of 193 donors matching perfectly for Rh, Duffy, Kell and Kidd antigens was prepared for 15 alloimmunized patients. For non-alloimmunized 84 thalassaemic patients, a database of 405 donors was created.

Interpretation & conclusions:

A database of 500 regular blood donors phenotyped for common antigens of Rh, Duffy, Kell and Kidd blood group systems was created, which would be useful in providing extended antigen-matched RBCs for thalassaemia patients. This will improve the quality and effectiveness of transfusion therapy.

Demographics of Rhesus Phenotype of Blood Donors in Calabar: A Case Study of University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria

BACKGROUND

Rhesus antigens have been documented to cause haemolytic disease of the newborn as well as acute and delayed transfusion reactions. This study was performed to evaluate the frequency of rhesus antigens (C, c, D, E, and e) in the studied population.

METHOD

This study was a cross-sectional study involving 130 prospective blood donors attending University of Calabar Teaching Hospital (UCTH) donor clinic. Donors were grouped for Rh antisera (anti-E, anti-e, anti-C, anti-c, and anti-D) using the standard serologic technique.

RESULT

The most prevalent Rh antigen was "c" (98.5%), followed by "D" (97.7%), while the least was "C" (30.7%). The most prevalent phenotype was cDe/cDe (R0R0).

CONCLUSION

This work therefore concludes that the most prevalent rhesus antigen and rhesus phenotype was c and cDe/cDe among blood donors in University of Calabar Teaching Hospital.

Assessment of rhesus and kell blood group antigens, phenotypes, and their allelic frequencies in North Indian blood donors

BACKGROUND

Prevalence of rhesus (Rh) and Kell antigens in a population vary with race, ethnicity, and geographical location. With advances in immunohematology, non-D antigens, and their corresponding antibodies are increasingly being found to be culprits for alloimmunization.

MATERIALS AND METHODS

Assessment of the phenotype of Rh and Kell blood group antigen in the healthy donor population from North India was done, and estimation of the frequencies of these alleles in our population was performed.

RESULTS

The most common antigen in the North Indian donor population was "e" (95.6%) followed by "C" (89.6%), "c" (57.7%), and "E" (17.29%) in that order. The most prevalent phenotype in the Indian population was found to be "CDe" followed by "CcDe" and "CcDEe." "K" antigen was found to be positive in 1.81% of the population.

DISCUSSION

Knowledge of the Rh antigen profiles in a given population can be very helpful in formulating transfusion guidelines specific to a particular population with an aim to minimize the cost and maximize the benefits. With this aim in mind and considering the problems encountered in developing countries like ours, we conducted Rh and Kell antigen profiling of donors. Comparative analysis with other population studies and implications for transfusion protocols is evaluated.

CONCLUSION

Assessment of Rhesus antigen profile of a particular population is useful to develop cost effective ways of providing maximum benefits of blood transfusion with least resources.

ABO and Rhesus blood group distribution and frequency among blood donors at Kilimanjaro Christian Medical Center, Moshi, Tanzania

Objective

This study aims to determine the distribution of blood groups and the demographic background of blood donors in a referral hospital in Northern Tanzania.

Results

The most common blood group was O (52.3%) and the least common was AB (3.18%). 97.7% of the blood donors were Rh positive and the rest were Rh negative. Most donors were young adults, representing the age group of 19–29. The majority of donors were male (88.1%) and the majority (90.8%) were replacement while the remainder was voluntary donors.