Assessment of risks of feline mismatched transfusion and neonatal isoerythrolysis in the Lyon (France) area

Wild Felids Blood Group System

Wild felids and domestic cats share the AB blood group. However, there have been few studies regarding the characterization and prevalence of the different blood types in wild animals. The erythrocyte membrane glycolipids of the wild cats correspond to the major disialoganglioside patterns observed in domestic cats. Like in domestic cats, type A blood seems to be the most common, although wild felid species seem to exhibit one single blood type. Of the species studied, the wild domestic cats, and the Panthera and ocelot lineages, all had type A blood; the Puma lineage showed almost exclusively type B blood. The prevalence of wild felids blood types show that there seems to be variation between species, but not within species, and no evidence of geographical variation has yet been found, showing apparently no genetic variability. The presence of alloantibodies has also been demonstrated, so the risk of life-threatening transfusion reactions due to mismatched transfusions and neonatal isoerythrolysis is a possibility. Like in other species, the recognition of wild felids blood groups is clinically relevant, as it can also be important in establishing phylogenetic relationships within the Felidae family. We will review the current knowledge on this topic and give insights into the wild felids blood groups potential for zoo transfusion medicine and phylogenetic studies in order to help support reintroduction projects and to preserve genetic diversity.

Feline Blood Groups: A Systematic Review of Phylogenetic and Geographical Origin

Simple Summary

Numerous breeds have been identified in the domestic cat, grouped according to their phylogenetic or geographical origin. In the cat, the AB blood group system is the most important feline system, and the determination of the blood group by specific methods is an essential step to avoid or reduce the risk of an adverse reaction in the recipient patient. Many studies have been published on the distribution and prevalence of blood types in pedigree and non-pedigree cats, but the information has never been collated in a systematic manner.

Abstract

Domestic cats descended from the African wildcat several thousand years ago. Cats have spread to all parts of the world, probably along routes between civilizations or geographical boundaries, leading to the movement of species, from Asia to the African continent through the Mediterranean basin, and finally to the American continent, Australia, and New Zealand. Currently, 73 cat breeds are recognized by the International Cat Association. With the increasing interest in the selection of breeds, the determination of blood groups in cats has acquired importance over time. The AB blood group system is the most important blood system in cats, in which A, B, and AB or C blood groups are identified. This systematic review describes data from previously published reports about cat blood types and cat breeds. After applying specific criteria, 28 eligible studies were identified in which the prevalence percentages for each blood group in correlation with specific cat breeds were reported. The breeds were, in turn, divided into four groups according to their geographic and phylogenetic origins as follows: Asian cat breeds, American cat breeds, European cat breeds, and breeds from Oceania. Although numerous studies were carried out before 2021, gaps in the literature on the AB system and, in particular, the Mik group are highlighted.

2021 ISFM Consensus Guidelines on the Collection and Administration of Blood and Blood Products in Cats

PRACTICAL RELEVANCE

Blood and blood products are increasingly available for practitioners to use in the management of haematological conditions, and can be lifesaving and therapeutically useful for patients with anaemia and/or coagulopathies. It is important for feline healthcare that donors are selected appropriately, and transfusions of blood or blood products are given to recipients that will benefit from them. Complications can occur, but can be largely avoided with careful donor management and recipient selection, understanding of blood type compatibility, and transfusion monitoring.

CLINICAL CHALLENGES

Feline blood transfusion, while potentially a lifesaving procedure, can also be detrimental to donor and recipient without precautions. Cats have naturally occurring alloantibodies to red cell antigens and severe reactions can occur with type-mismatched transfusions. Blood transfusions can also transmit infectious agents to the recipient, so donor testing is essential. Finally, donors must be in good health, and sedated as appropriate, with blood collected in a safe and sterile fashion to optimise the benefit to recipients. Transfusion reactions are possible and can be mild to severe in nature. Autologous blood transfusions and xenotransfusions may be considered in certain situations.

EVIDENCE BASE

These Guidelines have been created by a panel of authors convened by the International Society of Feline Medicine (ISFM), based on available literature. They are aimed at general practitioners to provide a practical guide to blood typing, cross-matching, and blood collection and administration.

Frequency of Blood Types A, B and AB in a Population of Non-Pedigree Domestic Cats from Central Italy

Simple Summary

This study aimed to evaluate the frequency of AB blood groups in non-pedigree domestic cats in Central Italy. The presence of natural alloantibodies in the feline blood group system can cause life-threatening transfusion reactions due to mismatched transfusion and, depending on the parents’ blood type, can also account for hemolytic reactions in newborn kittens. Based on the frequency of the AB blood groups found in the 483 cats studied, a potential risk (6.5%) of acute hemolytic transfusion or neonatal reactions was calculated. Therefore, determining the blood group in non-pedigree domestic cats from Central Italy before transfusion is strongly recommended, as has been reported for other geographical areas. Moreover, particular attention should be paid to the mating of non-purebred cats.

Abstract

Blood transfusion reactions and neonatal isoerythrolysis are common events in the feline population due to the presence of natural alloantibodies in the AB blood group system. It is known that the frequency of feline blood types varies according to the geographic region and breed. Therefore, the aims of this study were to investigate the frequency of AB blood groups in non-pedigree domestic cats in Central Italy and estimate the risk of a life-threatening transfusion reaction and neonatal isoerythrolysis, caused by mismatched transfusion or incompatible random mating, respectively. The AB blood group was determined on non-pedigree domestic feline patients and potential blood donors submitted at the Veterinary Teaching Hospitals of the Universities of Teramo (Abruzzo Region, Teramo, Italy) and Perugia (Umbria Region, Teramo, Italy), and visited at veterinary practitioners in Rome (Lazio Region, Teramo, Italy) using commercial immunochromatographic cartridges and commercial agglutination cards. There were four hundred and eighty-three cats included in the study. The frequencies of the blood types were: 89.9% type A, 7.0% type B, and 3.1% type AB. The probability of an acute hemolytic transfusion reaction or a neonatal isoerythrolysis was 6.5%. Although the frequency of type B in non-pedigree domestic cats living in Central Italy was relatively low, to reduce the risk of fatal transfusion reactions, blood group typing is recommended before each transfusion.

Prevalence of Blood Types and Alloantibodies of the AB Blood Group System in Non-Pedigree Cats from Northern (Lombardy) and Southern (Sicily) Italy

Simple Summary

The most important blood group system in cats is the AB, in which cats are classified as type-A, B or AB. Cats have antibodies against the blood type they do not possess, called alloantibodies. The aims of this study were to update blood type prevalence in cats from Northern Italy and study for the first time the blood type in cats from an insular region of Southern Italy, Sicily; to detect alloantibodies in these feline populations; to compare results with previous studies performed in Italy and between regions in Northern and Southern Italy. Cats from Southern Italy had the highest prevalence of type-B and type-AB, and the lowest prevalence of type-A blood in Italy. In particular, type-AB prevalence was higher than all previous reports in non-pedigree cats in Europe and the Italian prevalence of anti-type-B alloantibodies in type-A cats was the lowest reported worldwide. These results highlight the usefulness of regional studies to report different prevalences in feline blood types. Compatibility tests such as blood typing and cross matching must be considered fundamental in cats of any origin to ensure safe and efficient blood transfusion and to prevent neonatal isoerythrolysis.

Abstract

The aims of this study were to determine the prevalence of A, B and AB blood types and alloantibodies in non-pedigree cats from two regions, one in Northern and one in Southern Italy (Lombardy and Sicily, respectively). A total of 448 samples (52.0% from Northern and 48.0% from Southern Italy) were blood typed. The prevalence of A, B and AB blood types in northern and southern cats were 91.0%, 5.2%, 3.8%, and 77.2%, 12.1% and 10.7%, respectively. The prevalence of type-A blood in southern cats was significantly lower (p = 0.0001) than in northern cats, while type-B and AB blood were significantly higher (p = 0.0085 and p = 0.0051, respectively) in Southern compared to Northern Italian cats. Alloantibodies against type-A blood were found in 94.1% of type-B cats, 11.2% of type-A cats had alloantibodies against type-B blood, while no type-AB cats had alloantibodies with no significant difference between the two Italian populations. Type-AB prevalence in non-pedigree cats in Southern Italy was the highest reported in Europe. Italian type-A cats had the lowest worldwide prevalence of alloantibodies against type-B blood. These results highlight the usefulness of regional studies to report different prevalences in feline blood types and reinforce the importance of blood typing cats before transfusions and mating.

The Prevalence of Blood Groups in Domestic Cats in the Saskatoon and Calgary Areas of Saskatchewan and Alberta, Canada

The purpose of this study was to evaluate blood types of domestic cats in two cities in Western Canada (Saskatoon, Saskatchewan and Calgary, Alberta), as well as to determine the risk of mismatched transfusion and neonatal isoerythrolysis. Several cat studies around the world have shown variability in the prevalence of blood types in domestic and pedigree cats. Canadian data based on feline blood types is based out of Montreal. In this study the cohort of cats revealed a higher than anticipated prevalence; of 5% type B and 0.6% AB blood types. In our study, blood typing was performed in 400 domestic cats; 200 in Saskatoon and 200 in Calgary. Blood typing was performed using the gel tube method and the risk of transfusion mismatch (MT) was estimated by adding the risk of a major transfusion reaction and the risk of a minor transfusion reaction. The risk of neonatal isoerythrolysis (NI) was estimated according to the equation (p²)(q²) + 2pq(q²), with q being the b allele frequency and p = 1 – q. There was an identical frequency for feline blood types in both Saskatoon and Calgary cats, with 96% type A, 4% type B, and 0% AB. Based on these percentages, the risks of MT and NI in domestic cats were 7.6 and 4 % respectively. The frequency of type B cats in the population was similar to that in the previous Canadian study. These results demonstrate regional differences in prevalence of type B blood in domestic shorthairs across the world and serve to reinforce recommendations to blood type prior to transfusion or mating.