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

Harnessing the potential of blood donors negative for high prevalence Rh antigens: A Database Initiative for Thalassaemia Care

BACKGROUND AND OBJECTIVES

With increasing life expectancy and prevalence of thalassaemia, it has led to a greater need for safe blood, yet the current supply from voluntary donors is insufficient to meet this demand. Thalassaemia recipients face a significant risk of alloimmunization because of repeated exposure to foreign red cell antigens. Study aims to determine high prevalent Rh antigen negative donors in western India donor population along with what percentage of these donors are willing to become dedicated voluntary donors for thalassaemia patients. Study also aims to examine factors influencing their willingness and challenges faced in mobilizing dedicated donors.

METHOD

700 whole blood donors from western India, following screening for inclusion & exclusion criteria as per Drugs and Cosmetic Act (DCA) 2020 amendment guidelines & were sero-negative for transfusion transmitted infections were enrolled for the study. Red cell phenotyping was performed using Conventional Tube Technique (CTT) for "D", "C", "E", "c", "e" and "K" antigen using known antisera. Donors that were "C" AND/OR "e" antigen negative were contacted telephonically and were counseled and motivated for becoming voluntary blood donors. Statistical analysis assessed correlation between donation frequency, donor's occupation and education.

RESULT

Among 700 donors, 96.6% (n=676) were males and 3.4% (n=24) were females. The most predominant blood group was B > O > A > AB. Rh(D) antigen was present in 91.44% (n = 640) and absent in 8.6% (n=60). Prevalence of other Rh antigens is as follows: "e" (99%) > "C" (85.4%) > "c" (59.1%) > "E" (18.0%). Only 1.15% had "K" antigen positive. The commonest Rh phenotype R1R1 (DCe/DCe) was expressed by 40.57% (n=283), and the least common r"r (cE/ce), r''r''(cE/cE) and r'r' (Ce/Ce) was found in 0.14% (n=1), respectively. 'C' negative, 'e' negative, 'C' and 'e' antigen negative donors constituted 14.8% (n = 104) with 93.2% (n=97) C-antigen negative, 1.92% (n=2) e-antigen negative and 4.8% (n=5) both "C" and "e" antigen negative donors. The commonest phenotypes among C-antigen and e-antigen negative donors were rr (50%) and RzR2 (1.94%) respectively. Likewise, the most common phenotype amongst both C- and e-antigens negative donors was R2R2 (3.84%). 61.5% of the donors agreed to enroll for voluntary blood donation following telephonic invitation, while 6.8% of them refused permanently. Approximately, 3.9% of the blood donors were willing to donate blood only when needed and 27.8% of them could not be contacted.

CONCLUSION

Creating a database of voluntary donors with known phenotype, especially who lack very common antigens like "C" and "e" and are willing to become dedicated, regular voluntary donors for thalassemic patients can ensure timely administration of safe blood. One of the major challenges for this noble initiative was lack of awareness which can be circumvent effectively with proper counseling efforts.

Red Blood Cell Membrane-Coated Nanoparticles Enable Incompatible Blood Transfusions

Blood transfusions save lives and improve health every day. Despite the matching of blood types being stricter than it ever has been, emergency transfusions among incompatible blood types are still inevitable in the clinic when there is a lack of acceptable blood types for recipients. Here to overcome this, a counter measure nanoplatform consisting of a polymeric core coated by a red blood cell (RBC) membrane is developed. With A-type or B-type RBC membrane camouflaging, the nanoplatform is capable of specifically capturing anti-A or anti-B IgM antibodies within B-type or A-type whole blood, thereby decreasing the corresponding IgM antibody levels and then allowing the incompatible blood transfusions. In addition to IgM, the anti-RBC IgG antibody in a passive immunization murine model can likewise be neutralized by this nanoplatform, leading to prolonged circulation time of incompatible donor RBCs. Noteworthily, nanoplatform made by expired RBCs (>42 days stored hypothermically) and then subjected to lyophilization does not impair their effect on antibody neutralization. Most importantly, antibody-captured RBC-NP do not exacerbate the risk of inflammation, complement activation, and coagulopathy in an acute hemorrhagic shock murine model. Overall, this biomimetic nanoplatform can safely neutralize the antibody to enable incompatible blood transfusion.

Prevalence of blood group antigens among regular blood donors: A single center study from South India with a review of national literature

BACKGROUND AND OBJECTIVES

The antigen frequencies vary across different regions and ethnic groups. Hence, we aimed to study the prevalence of blood group antigens in our population and to systemize the zone-wise prevalence of the same across India.

MATERIALS AND METHODS

Regular voluntary O group blood donors were screened for 21 blood group antigens; C, c, E, e, K, k, Kpa, Kpb, Jka, Jkb, Fya, Fyb, Lea, Leb, Lua, Lub, P1, M, N, S, s, using commercially available monoclonal antisera by column agglutination technology. A literature search was performed to identify all the studies that reported blood group antigens prevalence to estimate the zone-wise prevalence of these antigens in the country.

RESULTS

A total of 521 participants of 9248 O group donors meeting all the inclusion criteria were included. Among the study group, the male-to-female ratio was 9:1 with a mean age of 32.6 years (±10.01) ranging from 18-60 years. The majority of the donors 446 (85.6%) were D positive. The most common phenotypes among Rh, Lewis, Kell, Duffy, Kidd, Lutheran and MNSs were CcDee (34.93%), Le(a-b+) (61.80%), K-k+(98.27%), Fy(a+b-) 43.19%, Jk(a+b+) 42.61%, Lu(a-b+) ( 99.61%), M+N+ (48.17%), S-s+ (45.29%) respectively. The prevalence of D and E antigens was significantly lower in the South zone compared to other zones of India.

CONCLUSION

Significant difference in the prevalence of blood group antigens is observed between the South and other zones of India. Zone-wise prevalence of blood group phenotypes is essential in the timely management of alloimmunized patients.

Frequency of Extended Red Cell Antigen Phenotype Among Patients of Hematological Diseases: A Single Center Study

Background

Alloimmunization of erythrocytes is a major problem in patients with hematological diseases that require frequent blood transfusions. Matching of extended red cell antigens of Kell, MNS, Kidd, and Duffy can decrease the risk of alloimmunization. Hence, in this study, the frequencies of the extended red cell phenotypes were explored.

Objective

To find out the frequency of extended red blood cell antigen phenotypes among patients with hematological diseases.

Methods

This cross-sectional research study was performed on 488 patients diagnosed with hematological diseases who required blood transfusion at the National Institute of Blood Disease and Bone Marrow Transplantation Karachi for a period of 1.42 years from November 2019 to March 2021. The blood of patients was analyzed for antigen phenotypes of different blood group systems including Kell, MNS, Kidd, and Duffy. The data obtained were interpreted.

Results

Among the 488 patients, 284 (58.20%) patients were male, and 204 (41.80%) patients were female with a mean age of 8.1 years. Beta thalassemia was the most common hematological disease reported in 354 (72.5%) of the patients. The most common blood group was O positive reported in 182 (37.3%) of the patients followed by B positive blood group in 124 (25.4%). The frequencies of extended red cell antigen phenotypes in the patients were K antigen 14 (2.9%), Kp^a antigen 26 (5.3%), Kp^b antigen 424 (86.9%), Fy^a antigen 360 (73.8%), Fy^b antigen 260 (53.3%), Jk^a antigen 294 (60.2%), Jk^b antigen 326 (66.8%), M antigen 410 (84.0%) and N antigen 306 (62.7%).

Conclusion

Beta thalassemia was the most common hematological disease followed by iron deficiency anemia, aplastic anemia, and acute leukemia. Patients with hematological diseases had a higher prevalence of Kp^b antigen followed by M, Fy^a, Jk^b, N, Jk^a, Fy^b, Kp^a, and K antigen. O positive was the most frequent blood group followed by B positive, A positive and AB positive blood group.

ABO and Rh Antigen Distribution Among Pregnant Women in South Western Uganda

Introduction

ABO and Rh are the major blood group systems in Transfusion Medicine, the ABO system based on two red cell antigens (A, B) while the Rh has about 50 antigens of which five are highly clinically significant (D, C, c, E, e). These vary among races and ethnic groups. Blood type phenotype incompatibility between mother and fetus may result in antigen mismatch, triggering alloimmunization, and thus causing hemolytic transfusion reaction (HTR), which results in hemolytic disease of fetus and newborn (HDFN). This study aimed to determine the frequencies of ABO and rhesus blood group antigen in the pregnant women in South Western Uganda.

Methods

A cross-sectional study was carried out on 1369 pregnant women who were recruited and provided consent to participate during their regular antenatal visits between August 2020 and July 2021. Four milliliters (4mL) of EDTA-anti-coagulated blood samples were collected and ABO and Rh-blood grouping including Rh antigen screening was done using the agglutination technology comprised of glass beads and reagent contained in a column of the Ortho Biovue ID Micro Typing System (Ortho Clinical Diagnostics, New Jersey, USA). The Rh antigen phenotypes and frequencies were then determined.

Results

There was percentage distribution of 99.8%, c 99.3%, D 94.3%, C 19.2% and E 15.9%, with Rh cDe/cDe (65.1%) being the most common phenotype followed by cDe/CDe (15%), cDe/cDE (10.8%) and cDE/cDE 0.1% least common. The ABO grouping frequency was obtained as O 49.4%, A 29.5%, B 17.0% and AB 4.1%, with D positivity at 94.3%.

Discussion

Population genetic variations result in varied expressions of red cell antigens that may have clinical complications. Knowledge of the presence of these Rh antigen distributions and phenotype frequencies during pregnancy help in rational management of the pregnancy, alloimmunization and better approach to safe blood transfusion.

Prevalence of major blood group antigens in blood donors at a main donation center in United Arab Emirates

Blood transfusion is a common practice in hospitals. In many diseases, transfusion of red blood cells can be a life-saving measure. Knowing the blood group phenotypes of the donors in any population is important to improve health care services and to better serve patients. We aimed to determine the blood group phenotypes of the regular donors visiting the main blood donation center in Sharjah, United Arab Emirates (UAE). A total of 500 regular blood donors were included, and blood group antigens were tested using serologic methods. Major blood group systems included in this testing were ABO, Rh, Kell, Kidd, Duffy, Lewis, Lutheran, MNS, and P1PK. The most prevalent ABO/D blood type was group O, D+ (29.6%), with the most prevalent phenotype in the Rh blood group system reported as R₁r (34.4%). In the Kell system, the K-k+ phenotype was reported in 92.4 percent of individuals tested. The rare Duffy null phenotype, Fy(a-b-), was reported in 11.0 percent of the cohort. Most donors (99.0%) were Lu(b+). In the Lewis system, the phenotype Le(a-b+) was seen in 61.8 percent of the donors. MNS system phenotypes were comparable to the reports from Saudi Arabia and India, with M+N+S-s+ being the most prevalent (21.2%). The prevalence of many major blood group phenotypes in the UAE blood donor population showed similarities to results from populations in neighboring countries, but other phenotype prevalences were unique to this population. This finding can be used to build a blood group registry for the local population that can better serve hospitals' transfusion requirements.

Blood transfusion is a common practice in hospitals. In many diseases, transfusion of red blood cells can be a life-saving measure. Knowing the blood group phenotypes of the donors in any population is important to improve health care services and to better serve patients. We aimed to determine the blood group phenotypes of the regular donors visiting the main blood donation center in Sharjah, United Arab Emirates (UAE). A total of 500 regular blood donors were included, and blood group antigens were tested using serologic methods. Major blood group systems included in this testing were ABO, Rh, Kell, Kidd, Duffy, Lewis, Lutheran, MNS, and P1PK. The most prevalent ABO/D blood type was group O, D+ (29.6%), with the most prevalent phenotype in the Rh blood group system reported as R₁r (34.4%). In the Kell system, the K–k+ phenotype was reported in 92.4 percent of individuals tested. The rare Duffy null phenotype, Fy(a–b–), was reported in 11.0 percent of the cohort. Most donors (99.0%) were Lu(b+). In the Lewis system, the phenotype Le(a–b+) was seen in 61.8 percent of the donors. MNS system phenotypes were comparable to the reports from Saudi Arabia and India, with M+N+S–s+ being the most prevalent (21.2%). The prevalence of many major blood group phenotypes in the UAE blood donor population showed similarities to results from populations in neighboring countries, but other phenotype prevalences were unique to this population. This finding can be used to build a blood group registry for the local population that can better serve hospitals’ transfusion requirements.