1
|
Van Buren NL, Gillen B, Lomas-Francis C, Burgos A, Pease D, Beaver M, Imbryk A, Dugger J, Fugate A, Hebel E, Lodermeier M, Vege S, Westhoff CM. YTGT: A new high-prevalence antigen in the Yt blood group system in two unrelated Native Americans and transfusion management. Transfusion 2022; 62:1917-1922. [PMID: 35904131 DOI: 10.1111/trf.17001] [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: 01/21/2022] [Revised: 05/11/2022] [Accepted: 05/15/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Yt system consists of five antigens: antithetical Yta /Ytb and the high-prevalence antigens YTEG, YTLI, and YTOT. We investigated a sample from a Native American (NA) female with post-operative anemia and an unidentified antibody who developed rigors, tachycardia, and hypotension on transfusion of incompatible RBCs. METHODS AND MATERIALS Serologic testing methods included LISS, PEG, and IgG gel. Test RBCs were treated with papain, trypsin, alpha-chymotrypsin, 2-amino-ethylisothiouronium, and dithiothreitol. Rare RBCs were tested, and inhibition studies were performed. DNA extracted from WBCs was used for Sanger sequencing. RESULTS Initial testing showed strong 3-4+ plasma reactivity with all panel cells at LISS IAT; auto control was negative. Positive reactions were observed with numerous rare RBCs except for PNH-III, which lack GPI-linked DO, Yt, CROM, JMH, and Emm. Enzyme sensitivity patterns suggest Yt specificity, and soluble recombinant srYt neutralized reactivity. ACHE sequencing revealed YT*A/A genotype but with a homozygous change in exon 2, c.290A>G (p.Gln97Arg). Antibody reactivity was reminiscent of that seen in an unrelated NA male investigated previously. His RBCs were nonreactive with her plasma. ACHE carried the same c.290G/G change. CONCLUSION Two unrelated NA patients were found to have an antibody to a new high-prevalence Yt antigen, designated YTGT (YT6), associated with a clinically significant transfusion reaction. Identification of the specificity relied on enzyme sensitivity, use of PNH-III RBCs, neutralization using soluble recombinant Yt, and the finding of a novel change in ACHE, c.290A>G (p.Gln97Arg), designated YT*01. ̶ 06. IVIG and steroids were used to mitigate further reactions to transfusion.
Collapse
Affiliation(s)
- Nancy L Van Buren
- Innovative Blood Resources, division of New York Blood Center, Saint Paul, Minnesota, USA.,Department of Laboratory Medicine and Pathology, Transfusion Services, Hennepin Healthcare HCMC, Minneapolis, Minnesota, USA
| | - Barbara Gillen
- Innovative Blood Resources, division of New York Blood Center, Saint Paul, Minnesota, USA
| | | | - Anna Burgos
- Immunohematology and Genomics Laboratory, New York Blood Center, New York, New York, USA
| | - Daniel Pease
- Department of Internal Medicine, Cancer/Hematology, Hennepin Healthcare HCMC, Minneapolis, Minnesota, USA
| | - Maria Beaver
- Department of Laboratory Medicine and Pathology, Essentia Health, Duluth, Minnesota, USA
| | - Adam Imbryk
- Innovative Blood Resources, division of New York Blood Center, Saint Paul, Minnesota, USA
| | - Julia Dugger
- Innovative Blood Resources, division of New York Blood Center, Saint Paul, Minnesota, USA
| | - Alexandra Fugate
- Innovative Blood Resources, division of New York Blood Center, Saint Paul, Minnesota, USA
| | - Eric Hebel
- Innovative Blood Resources, division of New York Blood Center, Saint Paul, Minnesota, USA
| | - Michelle Lodermeier
- Innovative Blood Resources, division of New York Blood Center, Saint Paul, Minnesota, USA
| | - Sunitha Vege
- Immunohematology and Genomics Laboratory, New York Blood Center, New York, New York, USA
| | - Connie M Westhoff
- Immunohematology and Genomics Laboratory, New York Blood Center, New York, New York, USA
| |
Collapse
|
2
|
Branch DR, Sandhu G, Raos M. Monocyte monolayer assay predictions of clinical outcome for serologically incompatible red blood cells is all about timing. Transfusion 2021; 61:2516-2517. [PMID: 34365664 DOI: 10.1111/trf.16556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Donald R Branch
- Centre for Innovation, Canadian Blood Services, Toronto, Ontario, Canada
| | - Gurleen Sandhu
- Centre for Innovation, Canadian Blood Services, Toronto, Ontario, Canada
| | - Mirela Raos
- Clinical Department of Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia
| |
Collapse
|