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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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2
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Srivastava K, Khil PP, Sippert E, Volkova E, Dekker JP, Rios M, Flegel WA. ACKR1 Alleles at 5.6 kb in a Well-Characterized Renewable US Food and Drug Administration (FDA) Reference Panel for Standardization of Blood Group Genotyping. J Mol Diagn 2020; 22:1272-1279. [PMID: 32688055 DOI: 10.1016/j.jmoldx.2020.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/17/2020] [Accepted: 06/26/2020] [Indexed: 12/18/2022] Open
Abstract
The glycoprotein encoded by the ACKR1 gene expresses the Duffy blood group antigens and is a receptor for malaria parasites. We recently described 18 long-range ACKR1 alleles in an autochthonous population of a malaria endemic region. Extending this work, we sequenced the gene in a 53-sample repository established by the US Food and Drug Administration (FDA) as reference reagents for blood group genotyping. The FDA samples have been characterized for 19 genes; however, long-range haplotype information for these genes, including ACKR1, was lacking. We used a hybrid approach, novel for this type of gene, to characterize ACKR1 by combining two next-generation sequencing technologies, the short-read massively parallel sequencing and the long-read nanopore sequencing. The expedient integration of data from both next-generation sequencing systems were necessary and sufficient to allow determination of all 25 long-range ACKR1 alleles found in the 53 samples accurately. All 25 alleles identified in our current FDA cohort were novel and, unexpectedly, none had been observed among the 18 alleles in our previous study. The alleles will be useful for validation, calibration, and proficiency testing of red cell genotyping. The lack of any overlap between the ACKR1 alleles in the two studies documents differences in mutation rate and recombination frequency among populations. The exact haplotype and their interethnic or interpopulation dissimilarities can influence disease susceptibility and therapy.
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Affiliation(s)
- Kshitij Srivastava
- Department of Transfusion Medicine, NIH Clinical Center, NIH, Bethesda, Maryland
| | - Pavel P Khil
- Laboratory Medicine, NIH Clinical Center, NIH, Bethesda, Maryland
| | - Emilia Sippert
- Office of Blood Research and Review, Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland
| | - Evgeniya Volkova
- Office of Blood Research and Review, Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland
| | - John P Dekker
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland
| | - Maria Rios
- Office of Blood Research and Review, Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland
| | - Willy A Flegel
- Department of Transfusion Medicine, NIH Clinical Center, NIH, Bethesda, Maryland.
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3
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Quirino MG, Colli CM, Macedo LC, Sell AM, Visentainer JEL. Methods for blood group antigens detection: cost-effectiveness analysis of phenotyping and genotyping. Hematol Transfus Cell Ther 2018; 41:44-49. [PMID: 30793104 PMCID: PMC6371408 DOI: 10.1016/j.htct.2018.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 06/07/2018] [Indexed: 11/24/2022] Open
Abstract
Background Alloimmunization is a major problem in transfusion practice due to the clinical complications of the patients and the difficulty of choosing a unit of compatible blood product. Serological methods are widely used in blood banks, but they not always determine the phenotype. Thus, genotyping is an important complement to the serology tool as it allows one to predict the phenotype from deoxyribonucleic acid (DNA) with high accuracy. Objective To compare the centrifugation gel, microarray, Restriction Fragment Length Polymorphismone PCR (PCR-RFLP) and Sequence-Specific Primer PCR (PCR-SSP) techniques, in terms of cost, reaction time and reliability of the results. Methods The RHCE, Kidd, Kell and Duffy blood group systems were chosen to determine the approximate cost of each technique, considering the reagents used in both methods and considering only one sample. The time required for the development of each reaction was obtained at the Maringa Regional Blood Center and Immunogenetics Laboratory at the State University of Maringa. Data from Microarray reactions were obtained at the Campinas Blood Center. The results of phenotyping and genotyping of the 16 samples were compiled in a spreadsheet and compared. Results The PCR-SSP was more economical compared to other methods, and the serological method was faster than the molecular methods. However, all methods proved to be effective and safe in the detection of erythrocyte antigens. Conclusion Analyzing the advantages and limitations of the molecular and serological methods tested in this study, we note that both are important and complementary. However, the choice of a methodology depends on the reality and needs of each health service.
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Affiliation(s)
| | | | | | - Ana Maria Sell
- Universidade Estadual de Maringá (UEM), Maringá, PR, Brazil
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4
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Allen ES, Nelson RC, Flegel WA. How we evaluate red blood cell compatibility and transfusion support for patients with sickle cell disease undergoing hematopoietic progenitor cell transplantation. Transfusion 2018; 58:2483-2489. [PMID: 30403414 DOI: 10.1111/trf.14871] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 06/11/2018] [Accepted: 06/12/2018] [Indexed: 12/23/2022]
Abstract
Multiple hematopoietic progenitor cell (HPC) transplantation options for patients with sickle cell disease (SCD) are currently under investigation. Patients with SCD have a high rate of alloimmunization to red blood cell antigens, often complicating transfusion support. Transfusion reactions, including acute and delayed hemolytic reactions, have been observed despite immunosuppressive regimens. Allogeneic donor transplants have been shown to carry a risk of prolonged reticulocytopenia and acute hemolysis with severe anemia in nonmyeloablative regimens. We discuss our experience providing transfusion support to patients with SCD undergoing HPC transplantation, propose an outline for a complete pretransplantation evaluation, and discuss donor/recipient compatibility issues and their implications.
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Affiliation(s)
- Elizabeth S Allen
- Department of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, Maryland.,Department of Pathology, University of California at San Diego, La Jolla, California
| | - Randin C Nelson
- Department of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, Maryland.,Department of Pathology, Montefiore Medical Center, Bronx, New York
| | - Willy A Flegel
- Department of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, Maryland
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5
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Ryzhov IM, Tuzikov AB, Perry H, Korchagina EY, Bovin NV. Blood Group O→A Transformation by Chemical Ligation of Erythrocytes. Chembiochem 2018; 20:131-133. [PMID: 30019804 DOI: 10.1002/cbic.201800289] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Indexed: 12/14/2022]
Abstract
Agglutination of red blood cells (RBCs) remains the only practical method for routine use for ABH typing in clinical practice. However, exact mechanistic details of agglutination are not yet thoroughly studied. In this research, RBCs of blood group O were converted to blood group A through two approaches: by chemical ligation of the cells' glycocalyx with synthetic blood group A tetrasaccharide, and by insertion of synthetic glycolipid carrying the same A antigen into the cells' membranes. The O→A ligated RBCs and natural A RBCs showed comparable agglutination characteristics with antibodies. As expected, RBCs with inserted glycolipid showed lower agglutination scores. This approach could help cell biologists in site-specific and cell-friendly modification of glycocalyx by other ligands.
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Affiliation(s)
- Ivan M Ryzhov
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, 117997, Moscow, Russia
| | - Alexander B Tuzikov
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, 117997, Moscow, Russia
| | - Holly Perry
- Centre for Kode Technology Innovation, School of Engineering, Computer & Mathematical Sciences, Auckland University of Technology, Auckland, 1010, New Zealand
| | - Elena Yu Korchagina
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, 117997, Moscow, Russia
| | - Nicolai V Bovin
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, 117997, Moscow, Russia.,Centre for Kode Technology Innovation, School of Engineering, Computer & Mathematical Sciences, Auckland University of Technology, Auckland, 1010, New Zealand
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6
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Scharberg E, Rink G, Portegys J, Rothenberger S, Gillhuber N, Richter E, Bugert P. The Impact of Using Genotyped Reagent Red Blood Cells in Antibody Identification. Transfus Med Hemother 2018; 45:218-224. [PMID: 30283270 DOI: 10.1159/000491884] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 07/06/2018] [Indexed: 11/19/2022] Open
Abstract
Background The detection and identification of antibodies to red blood cell (RBC) antigens is one of the most important and challenging issues in transfusion medicine. Up to date there are 354 RBC antigens recognized by the International Society of Blood Transfusion (ISBT). The reagent RBCs used in commercial antibody screening and identification panels however are usually serologically typed for up to 40 clinically important antigens. Thus the identification of many antibody specificities remains impossible when using reagent RBCs with only limited information about their antigens. To improve the pre-transfusion diagnostics, we developed antibody identification panels with reagent RBCs serologically typed for 26 antigens and additionally genotyped for 30 blood group alleles. Methods The reagent RBCs in the panels were characterized serologically for the clinically most significant 'standard' antigens. The reagent RBC donors were additionally genotyped by using in-house PCR-SSP methods. The antibody identification was performed in the indirect antiglobulin test using untreated and papain-treated RBCs in the gel technique. Antibodies identified due to the genotype information were confirmed by serology using appropriate reference RBCs. Results Within a time period of 3 years and 8 months, 16,878 blood samples from 8,467 patients were tested in our reference laboratory. In total, 21 different antibodies from 10 different blood group systems could be identified in 126 patients (1.5%) due to the genotype information obtained for the reagent RBCs. Antibodies to antigens from the Knops system (53 patients; 42%, 8 patients with anti-Knb) and to Cartwright antigens (31 patients; 25%) were the most frequent. Conclusion The use of genotyped reagent RBCs in antibody identification panels extends the range of detectable antibody specificities, accelerates the antibody identification, and improves the pre-transfusion diagnostics.
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Affiliation(s)
- Erwin Scharberg
- Institute of Transfusion Medicine and Immunohematology, German Red Cross Blood Service Baden-Württemberg - Hesse, Baden-Baden, Germany
| | - Gabi Rink
- Institute of Transfusion Medicine and Immunology, Heidelberg University, Medical Faculty Mannheim, German Red Cross Blood Service Baden-Württemberg - Hessen, Mannheim, Germany
| | - Jan Portegys
- Institute of Transfusion Medicine and Immunology, Heidelberg University, Medical Faculty Mannheim, German Red Cross Blood Service Baden-Württemberg - Hessen, Mannheim, Germany
| | - Sina Rothenberger
- Institute of Transfusion Medicine and Immunohematology, German Red Cross Blood Service Baden-Württemberg - Hesse, Baden-Baden, Germany
| | - Nicole Gillhuber
- Institute of Transfusion Medicine and Immunohematology, German Red Cross Blood Service Baden-Württemberg - Hesse, Baden-Baden, Germany
| | - Ekkehard Richter
- Institute of Transfusion Medicine and Immunohematology, German Red Cross Blood Service Baden-Württemberg - Hesse, Baden-Baden, Germany
| | - Peter Bugert
- Institute of Transfusion Medicine and Immunology, Heidelberg University, Medical Faculty Mannheim, German Red Cross Blood Service Baden-Württemberg - Hessen, Mannheim, Germany
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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.
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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
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9
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Fichou Y, Mariez M, Le Maréchal C, Férec C. The experience of extended blood group genotyping by next-generation sequencing (NGS): investigation of patients with sickle-cell disease. Vox Sang 2016; 111:418-424. [PMID: 27442304 DOI: 10.1111/vox.12432] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 06/04/2016] [Accepted: 06/06/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND Patients suffering from haemoglobinopathies may be treated by red blood cell (RBC) transfusion on a regular basis and then exposed to multiple antigens with a recurrent, potential risk of alloimmunization routinely prevented by extended RBC antigen cross-matching. While time-consuming and labour-intensive serological analyses are the gold standard for RBC typing, genotyping by current high-throughput molecular tools, including next-generation sequencing (NGS), appears to offer a potent alternative. STUDY DESIGN AND METHODS The potential of extended blood group genotyping (EBGG) by NGS of 17 genes involved in 14 blood group systems was evaluated in a cohort of 48 patients with sickle-cell disease. Sample preparation and sequencing were simplified and automated for future routine implementation. RESULTS Sequencing data were obtained for all DNA samples with two different sequencing machines. Prediction of phenotypes could be made in 12 blood group systems and partially in two other blood group systems (Rh and MNS). Importantly, predicted phenotypes in the MNS (S/s), Duffy, Kidd and Kell systems matched well with serological data (98·9%), when available. Unreferenced alleles in the ACHE and ART4 genes, respectively, involved in the Yt and Dombrock blood groups, were identified, then contributing to extend the current knowledge of blood group molecular genetics. CONCLUSIONS Overall, we consider that our strategy for NGS-based EBGG, assisted by a simple method for genotyping exons 1 and 2 of the pairs of homologous genes (i.e. RHD/RHCE and GYPA/GYPB), as well as the future support of potent bioinformatics tools, may be implemented for routine diagnosis in specific populations.
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Affiliation(s)
- Y Fichou
- Etablissement Français du Sang (EFS) - Région Bretagne, Brest, France.,Institut National de la Santé et de la Recherche Médicale (Inserm), UMR1078, Brest, France
| | - M Mariez
- Etablissement Français du Sang (EFS) - Région Bretagne, Brest, France.,Institut National de la Santé et de la Recherche Médicale (Inserm), UMR1078, Brest, France
| | - C Le Maréchal
- Etablissement Français du Sang (EFS) - Région Bretagne, Brest, France.,Institut National de la Santé et de la Recherche Médicale (Inserm), UMR1078, Brest, France.,Laboratoire de Génétique Moléculaire et d'Histocompatibilité, Centre Hospitalier Régional Universitaire (CHRU), Hôpital Morvan, Brest, France.,Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale (UBO), Brest, France
| | - C Férec
- Etablissement Français du Sang (EFS) - Région Bretagne, Brest, France.,Institut National de la Santé et de la Recherche Médicale (Inserm), UMR1078, Brest, France.,Laboratoire de Génétique Moléculaire et d'Histocompatibilité, Centre Hospitalier Régional Universitaire (CHRU), Hôpital Morvan, Brest, France.,Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale (UBO), Brest, France
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10
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Rink G, Scharberg EA, Bugert P. PCR with sequence-specific primers for typing of diallelic blood groups. Methods Mol Biol 2016; 1310:71-81. [PMID: 26024626 DOI: 10.1007/978-1-4939-2690-9_6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PCR with sequence-specific primers (PCR-SSP) is a cost-effective and robust method for the analysis of single nucleotide polymorphisms (SNPs). Many blood group antigens and the antithetic antigens are based on a diallelic SNP in the coding region of the corresponding blood group gene. Here, we describe PCR-SSP protocols for genotyping 24 blood group antigens based on 12 diallelic SNPs. We also provide protocols for molecular determination of the rare blood group phenotypes Yk(a-) and Vel-.
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Affiliation(s)
- Gabriele Rink
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, German Red Cross Blood Service Baden-Württemberg - Hessen gGmbH, Heidelberg University, Friedrich-Ebert-Straße 107, 68167, Mannheim, Germany,
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11
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Molecular immunohaematology round table discussions at the AABB Annual Meeting, Philadelphia 2014. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2015; 14:425-33. [PMID: 26710354 DOI: 10.2450/2015.0130-15] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 09/07/2015] [Indexed: 11/21/2022]
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12
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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.
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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
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13
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Affiliation(s)
- E. A. Scharberg
- Institute for Transfusion Medicine and Immunohematology; Red Cross Blood Service of Baden-Wuerttemberg-Hessen; Baden-Baden Germany
| | - E. Richter
- Institute for Transfusion Medicine and Immunohematology; Red Cross Blood Service of Baden-Wuerttemberg-Hessen; Baden-Baden Germany
| | - P. Bugert
- Institute for Transfusion Medicine and Immunology; Medical Faculty Mannheim; Heidelberg University; Red Cross Blood Service of Baden-Wuerttemberg-Hessen; Mannheim Germany
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14
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Affiliation(s)
- T. Peyrard
- Département Centre National de Référence pour les Groupes Sanguins; Institut National de la Transfusion Sanguine (INTS); Paris France
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15
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Belsito A, Costa D, Fiorito C, De Iorio G, Casamassimi A, Perrotta S, Napoli C. Erythrocyte genotyping for transfusion-dependent patients at the Azienda Universitaria Policlinico of Naples. Transfus Apher Sci 2015; 52:72-7. [PMID: 25582271 DOI: 10.1016/j.transci.2014.12.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Revised: 11/17/2014] [Accepted: 12/15/2014] [Indexed: 01/19/2023]
Abstract
BACKGROUND AND OBJECTIVES Although minor erythrocyte antigens are not considered clinically significant in sporadic transfusions, they may be relevant for multi-transfusion patients. When serological assay is not conceivable, molecular genotyping allows predicting the red blood cell phenotype, extending the typing until minor blood groups. The aim of this study was to evaluate the utility of blood group genotyping and compare the molecular typing of erythrocyte antigens with the established serological methods. MATERIALS AND METHODS We selected 225 blood donors and 50 transfusion-dependent patients at the Division of Immunohematology of the Second University of Naples. Blood samples were analyzed with NEO Immucor automated system and genotyped for 38 red blood cell antigens and phenotypic variants with the kit HEA BeadChip™. The comparative study was conducted for RhCE and Kell antigens whose typing is available with both methods. RESULTS We observed a good correlation between serological and molecular methods for donors that were concordant for 99.5% (224/225) and discordant for 0.5% (1/225). Patients resulted concordant only for 46.0% (23/50) and discordant for 54.0% (27/50); discrepancies were 46.0% (23/50) and 8.0% (4/50) for RhCE and Kell systems respectively. Through molecular genotyping we also identified polymorphisms in RhCE, Kell, Duffy, Colton, Lutheran and Scianna loci in donors and patients. CONCLUSIONS Blood group genotyping is particularly useful for poly-transfused patients. Molecular analysis confirms and extends serological test data and then allows us to obtain a better match. This molecular assay can be used in the future to prevent alloimmunization in transfusion-dependent patients.
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Affiliation(s)
- Angela Belsito
- U.O.C. Immunohematology, Transfusion Medicine and Transplant Immunology (SIMT), Regional Reference Laboratory of Transplant Immunology (LIT), Azienda Universitaria Policlinico (AOU), Second University of Naples (SUN), Italy; Department of Biochemistry, Biophysics and General Pathology, Second University of Naples (SUN), Italy.
| | - Dario Costa
- U.O.C. Immunohematology, Transfusion Medicine and Transplant Immunology (SIMT), Regional Reference Laboratory of Transplant Immunology (LIT), Azienda Universitaria Policlinico (AOU), Second University of Naples (SUN), Italy
| | - Carmela Fiorito
- U.O.C. Immunohematology, Transfusion Medicine and Transplant Immunology (SIMT), Regional Reference Laboratory of Transplant Immunology (LIT), Azienda Universitaria Policlinico (AOU), Second University of Naples (SUN), Italy
| | - Gustavo De Iorio
- U.O.C. Immunohematology, Transfusion Medicine and Transplant Immunology (SIMT), Regional Reference Laboratory of Transplant Immunology (LIT), Azienda Universitaria Policlinico (AOU), Second University of Naples (SUN), Italy
| | - Amelia Casamassimi
- Department of Biochemistry, Biophysics and General Pathology, Second University of Naples (SUN), Italy
| | - Silverio Perrotta
- Department of Women, Child and General and Specialistic Surgery, Second University of Naples (SUN), Italy
| | - Claudio Napoli
- U.O.C. Immunohematology, Transfusion Medicine and Transplant Immunology (SIMT), Regional Reference Laboratory of Transplant Immunology (LIT), Azienda Universitaria Policlinico (AOU), Second University of Naples (SUN), Italy; Department of Biochemistry, Biophysics and General Pathology, Second University of Naples (SUN), Italy
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