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Jacko G, Powley T, Daly J. Frequency of red blood cell phenotypes from genotyped Australian blood donors. Transfus Med 2024; 34:219-222. [PMID: 38659102 DOI: 10.1111/tme.13044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 04/11/2024] [Accepted: 04/13/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Australian Red Cross Lifeblood (Lifeblood) performs human erythrocyte antigen (HEA) genotyping for a subset of repeat whole-blood donors through preferential selection which aims to maximise variation of results and possibility of identifying donors lacking high frequency red cell antigens. MATERIALS AND METHODS The HEA Molecular Bead chip™ assay is used by Lifeblood for donor genotyping. A review of all donor HEA genotype data from March 2019 to May 2022 (3 years) was conducted. RESULTS HEA genotyping was performed for 20,185donors. Due to selective genotyping of donors, a higher frequency of R1R1 predicted phenotype was identified. However, frequencies of other red cell phenotypes were relatively similar to previous reported in the Australian population. A small number of donors with rare red cell phenotypes was identified. CONCLUSION Genotyping of blood donors provides an available pool of extended matched red blood cell products for matching to recipients. Additionally genotyping can improve the identification of donors with rare phenotypes. Whilst limitations exist, genotyping may reduce the need for labour intensive serotyping, improve blood inventory management, and may be useful in donor recruitment and retention.
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Affiliation(s)
- Georgina Jacko
- Pathology and Clinical Governance, Australian Red Cross Lifeblood, Brisbane, Queens Land, Australia
| | - Tanya Powley
- Pathology and Clinical Governance, Australian Red Cross Lifeblood, Brisbane, Queens Land, Australia
| | - James Daly
- Pathology and Clinical Governance, Australian Red Cross Lifeblood, Brisbane, Queens Land, Australia
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Bevel N, Thorpe M, Vanniasinkam T. Is drug interference still an issue for pretransfusion testing of patients on anti CD38 and other monoclonal antibody therapies? Vox Sang 2024. [PMID: 38705581 DOI: 10.1111/vox.13649] [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: 01/02/2024] [Revised: 03/03/2024] [Accepted: 03/28/2024] [Indexed: 05/07/2024]
Abstract
Certain therapies that target CD markers on some blood cells can affect pretransfusion testing. Key examples are anti-CD38, CD47 monoclonal antibody (mAb) therapies such as daratumumab (DARA) and magrolimab, which have presented a challenge for transfusion medicine laboratories around the globe. Scientists have been faced with not only introducing a protocol to provide safe blood to patients but also investigating the most effective method to remove the pretransfusion pan-agglutinating interference caused. A number of papers in the last 5 years have reported on various methods to remove pretransfusion interference; however, most of these studies have been conducted only in a few countries. Most recent reviews on this topic have focused on techniques and reagents to remove pretransfusion interference, and dithiothreitol is currently the gold standard for removing DARA interference. However, it was clear from this review that while many laboratories have developed processes for addressing interference in pretransfusion testing, and DARA interference may not be a major issue, there are still laboratories around the world, that may not have adequately addressed this issue. In addition, the impact of mAb interference on widely used techniques such as flow cytometry is unclear.
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Affiliation(s)
- Nichole Bevel
- School of Dentistry and Medical Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia
- Transfusion Medicine Laboratory, St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Meagan Thorpe
- Transfusion Medicine Laboratory, St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Thiru Vanniasinkam
- School of Dentistry and Medical Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia
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Jacko G, Thorpe R, Daly J. Equity in blood transfusion precision services. Int J Equity Health 2024; 23:77. [PMID: 38637779 PMCID: PMC11027542 DOI: 10.1186/s12939-024-02170-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 04/03/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Blood collection agencies are integrating precision medicine techniques to improve and individualise blood donor and recipient outcomes. These organisations have a role to play in ensuring equitable application of precision medicine technologies for both donors and transfusion recipients. BODY: Precision medicine techniques, including molecular genetic testing and next generation sequencing, have been integrated in transfusion services to improve blood typing and matching with the aim to reduce a variety of known transfusion complications. Internationally, priorities in transfusion research have aimed to optimise services through the use of precision medicine technologies and consider alternative uses of genomic information to personalise transfusion experiences for both recipients and donors. This has included focusing on the use of genomics when matching blood products for transfusion recipients, to personalise a blood donor's donation type or frequency, and longitudinal donor research utilising blood donor biobanks. CONCLUSION Equity in precision services and research must be of highest importance for blood collection agencies to maintain public trust, especially when these organisations rely on volunteer donors to provide transfusion services. The investment in implementing equitable precision medicine services, including development of blood donor biobanks, has the potential to optimise and personalise services for both blood donors and transfusion recipients.
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Affiliation(s)
- Georgina Jacko
- Pathology and Clinical Governance, Australian Red Cross Lifeblood, Brisbane, QLD, Australia.
| | - Rachel Thorpe
- Strategy and Growth, Australian Red Cross Lifeblood, Melbourne, VIC, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - James Daly
- Pathology and Clinical Governance, Australian Red Cross Lifeblood, Brisbane, QLD, Australia
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Hirani R, Powley T, Mondy P, Irving DO. The prevalence of selected clinically significant red blood cell antigens among Australian blood donors. Pathology 2024; 56:398-403. [PMID: 38142183 DOI: 10.1016/j.pathol.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/31/2023] [Accepted: 10/06/2023] [Indexed: 12/25/2023]
Abstract
Red blood cell (RBC) transfusion can cause some patients to form antibodies to RBC antigens when RBC phenotypes do not match that of the blood donor. Transfusion practitioners can order phenotyped RBC units for patients with known RBC antibodies or those who are at risk of forming them. However, with increasing demand for phenotyped RBC units, contemporary data on antigen prevalence is required to manage the changing supply. A total of 490,491 blood donors, including 103,798 (21.2%) first-time blood donors, from 2019 were analysed for the prevalence of selected clinically relevant blood group antigens. Prevalence of the phenotype R1R1 (D+ C+ E- c- e+) increased from the previous estimate of 17.3% to 24.0% in first-time blood donors. The prevalence of R1r (D+ C+ E- c+ e+) decreased from 35.3% to 30.8%. R1R1 was more common in blood donors born in Asia or the Middle East. The prevalence of Fy(a-b-) in donors where Fy antigens were tested was 0.2%. Of these, 71.8% stated their region of birth as Africa. The prevalence of Jk(a-b-) is 0.01% in donors where the Jk antigens were tested with region of birth stated as either Oceania or Asia. The increasing prevalence of the c-negative phenotype in R1R1 individuals is associated with the changing demographics of the Australian community. For R1R1 individuals with childbearing potential, the transfusion of RhD negative blood, which is usually c-positive, may increase the possibility of haemolytic disease of the fetus and newborn during pregnancy. Continued diversification of the Australian blood donor panel will support having the appropriate phenotyped RBC units available.
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Affiliation(s)
- Rena Hirani
- Australian Red Cross Lifeblood, Sydney, NSW, Australia; Macquarie University, Sydney, NSW, Australia.
| | - Tanya Powley
- Australian Red Cross Lifeblood, Brisbane, Qld, Australia
| | - Phillip Mondy
- Australian Red Cross Lifeblood, Sydney, NSW, Australia
| | - David O Irving
- Australian Red Cross Lifeblood, Sydney, NSW, Australia; University of Technology Sydney, Sydney, NSW, Australia
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Chen DP, Wu PY, Lin YH. Irregular Antibody Screening Using a Microdroplet Platform. BIOSENSORS 2023; 13:869. [PMID: 37754103 PMCID: PMC10526156 DOI: 10.3390/bios13090869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/29/2023] [Accepted: 08/31/2023] [Indexed: 09/28/2023]
Abstract
The screening procedure for antibodies is considered the most tedious among the three pretransfusion operations, i.e., ABO and Rhesus (Rh) typing, irregular antibody screening/identification, and crossmatching tests. The commonly used screening method for irregular antibodies in clinics at present is a manual polybrene test (MP). The MP test involves numerous reagent replacement and centrifuge procedures, and the sample volume is expected to be relatively less. Herein, screening red blood cells (RBCs) and serum irregular antibodies are encapsulated in microdroplets with a diameter of ~300 μm for a hemagglutination reaction. Owing to the advantage of spatial limitation in microdroplets, screening RBCs and irregular antibodies can be directly agglutinated, thereby eliminating the need for centrifugation and the addition of reagents to promote agglutination, as required by the MP method. Furthermore, the results for a large number of repeated tests can be concurrently obtained, further simplifying the steps of irregular antibody screening and increasing accuracy. Eight irregular antibodies are screened using the proposed platform, and the results are consistent with the MP method. Moreover, the volume of blood samples and antibodies can be reduced to 10 μL and 5 μL, respectively, which is ten times less than that using the MP method.
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Affiliation(s)
- Ding-Ping Chen
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan City 33305, Taiwan
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
| | - Pei-Yu Wu
- Department of Electronic Engineering, Chang Gung University, Taoyuan City 33302, Taiwan
| | - Yen-Heng Lin
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan City 33305, Taiwan
- Department of Biomedical Engineering, Chang Gung University, Taoyuan City 33302, Taiwan
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Ristovska E, Bojadjieva ТM, Velkova Е, Dimceva АH, Todorovski B, Tashkovska M, Rastvorceva RG, Bosevski M. Rare Blood Groups in ABO, Rh, Kell Systems - Biological and Clinical Significance. Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2022; 43:77-87. [PMID: 35843921 DOI: 10.2478/prilozi-2022-0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Background: The frequency of ABO, Rh and Kell blood group antigens differs among populations of different ethnic ancestry. There are low-frequency antigens (<1%) and high-frequency antigens (>90%). A rare blood group is defined as the absence of a high-frequency antigen in the general population, as well as absence of multiple frequent antigens within a single or multiple blood group systems. Aim: To perform red blood cell typing and to calculate the antigen and phenotype frequencies, in order to identify rare blood group donors within the clinically most important АВО, Rh and Kell systems. Material and Methods: АВО, Rh (D, C, E, c, e) and Kell (K) antigen typing was performed using specific monoclonal sera and microplate technique, while Cellano (k) typing was performed with a monoclonal anti-k, antihuman globulin and column agglutination technique. Weak ABO subgroups were determined using the absorption elution method or molecular genotyping (PCR-SSP). Results: ABO antigen frequency is: A (40.89%), O (34.22%), B (16.97%), AB (7.92%) and weak ABO subgroups (0, 009 %). The established genotypes were AxO1 (0, 0026%) and AxB (0, 001%). Rh antigen frequency is: D (85.79%), C (71.7%), c (76.0%), E (26.0%) and е (97.95%). The most common Rh pheno-type is the DCcee (32.7%) while the rarest phenotype is the DCCEE phenotype (0. 003%). The prevalence of K and k antigen is 7.5% and 99.94%, respectively. The frequency of the rare phenotype K+k- is 0.06%. Conclusion: Large scale phenotyping of blood group antigens enables the identification of blood donors with rare blood groups for patients with rare phenotypes or with antibodies to high-frequency antigens and to frequent antigens within one or more blood group systems.
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Affiliation(s)
- Elena Ristovska
- Institute for transfusion medicine, St Cyril and Methodius University, Medical Faculty, Skopje, RN Macedonia
| | | | - Еmilija Velkova
- Institute for transfusion medicine, St Cyril and Methodius University, Medical Faculty, Skopje, RN Macedonia
| | - Аnita Hristova Dimceva
- Institute for transfusion medicine, St Cyril and Methodius University, Medical Faculty, Skopje, RN Macedonia
| | - Bojan Todorovski
- Institute for transfusion medicine, St Cyril and Methodius University, Medical Faculty, Skopje, RN Macedonia
| | - Marija Tashkovska
- Institute for transfusion medicine, St Cyril and Methodius University, Medical Faculty, Skopje, RN Macedonia
| | - Rada Grubovic Rastvorceva
- Institute for transfusion medicine, St Cyril and Methodius University, Medical Faculty, Skopje, RN Macedonia
| | - Marijan Bosevski
- Clinic of cardiology, St Cyril and Methodius University, Medical Faculty, Skopje, RN Macedonia
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Gahan L, Gemelli CN, Kruse SP, Davison TE. Designing and testing an ethnic-ancestry question for Australian blood donors: Acceptability, feasibility, and understanding. Transfus Med 2022; 32:237-242. [PMID: 35451114 PMCID: PMC9320970 DOI: 10.1111/tme.12865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 03/09/2022] [Accepted: 04/03/2022] [Indexed: 11/29/2022]
Abstract
Objectives We aimed to evaluate the acceptability, feasibility, and understanding of a donor ethnic‐ancestry question with Australian blood donors. Background Ethnic‐ancestry assists blood collection agencies to meet the demand for rare blood‐types. However, there is no standard ethnicity question used by health/blood services around the world and we do not know how blood donors in Australia will respond to being asked for this information. Methods/Materials A survey and ethnic‐ancestry question was administered to a sample of donors (n = 506) to evaluate their views on being asked for their ethnic‐ancestry, test a comprehensive ethnic‐ancestry list, and determine the level of information required by donors. Results Donors reported being very comfortable providing their ethnic‐ancestry and the majority of donors found an ethnic‐ancestry option they were happy with (91.3%). Overall donors reported a high level of understanding of why ethnic‐ancestry was important to blood donation. However, when provided more information on why ethnic‐ancestry is required, donors reported increased understanding. Conclusion The findings from this study demonstrated that it is acceptable and feasible to introduce a comprehensive ethnic‐ancestry question for Australian blood donors. We also found that a greater understanding is achieved when a more comprehensive explanation for inclusion of the question is provided.
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Affiliation(s)
- Luke Gahan
- School of Social Sciences and Humanities, La Trobe University, Melbourne.,Clinical Services and Research, Australian Red Cross Lifeblood, Melbourne
| | - Carley N Gemelli
- Clinical Services and Research, Australian Red Cross Lifeblood, Melbourne
| | - Sarah P Kruse
- Clinical Services and Research, Australian Red Cross Lifeblood, Melbourne
| | - Tanya E Davison
- Clinical Services and Research, Australian Red Cross Lifeblood, Melbourne.,Monash Art, Design, and Architecture, Monash University, Melbourne, Australia
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