Molecular red cell genotyping of rare blood donors in South Africa to enhance rare donor-patient blood matching

Abstract

Background: Molecular red cell genotyping is devoid of serology limitations such as the scarcity of rare antisera and the possibility of inconclusive results due to biological interferences. Blood incompatibility can result in immune transfusion reactions such as haemolytic transfusion reactions or haemolytic disease of the foetus and newborn.Objective: The study aimed to use molecular red cell genotyping to identify rare blood group donors among South African blood donors.Methods: Red cell genotyping data were extracted retrospectively from the BIDS XT genotyping software in the Immunohaematology Reference Laboratory from January 2015 to August 2016. The ID CORE XT genotyping assay was used to identify the single nucleotide polymorphisms of 10 blood groups system alleles in 150 donors. Associations between the resultant genotypes and predicted phenotypes, ABO group, RhD type, race group and gender were studied.Results: Significant red cell genetic variability was noted among the numerous South African donor genotypes identified in this study. Genotyping further confirmed the presence of at least one of the 16 rare genotypes in 50 donors. Group O Black donors were associated with two rare blood types, while several other rare blood types were found only in White donors, supporting an association between ABO/Rh subtype, race group and rare blood types.Conclusion: Targeted screening of donors for antigen-negative rare blood units for patients should be done to reduce the risk of haemolytic transfusion reactions and haemolytic disease of the foetus and newborn.

Blood Group Testing

“…NGS is also suitable for identifying rare blood types without knowing specific antibodies (110,111). Currently, there are more rapid and cost-effective genotyping kits with multiplex capacity and high-throughput volumes, enabling affordable large-scale rare blood group genotyping (127).…”

Molecular characterisation of Duffy (FY) red blood cell variants among voluntary blood donors at the National Blood Grouping Testing Laboratory, Kenya

“…Comparing the results with other studies in different populations, there are some minor variations that were observed. In South Africa, black population Fy(a-b-) 39% while Fya+ Fyb+ was reported to be 2% (Govender et al, 2021). In Saudi Arabia, type Fy(a-b-) was identified in 11.11% (Benahadi et al, 2014).…”

Genomic analysis of KEL*03 and KEL*04 alleles among Thai blood donors

“…KEL*03 and KEL*04 allele frequencies among Thai blood donors were compared with those reported in Filipino, Southeast Asian, Chinese, Japanese, Korean, South Asian, Native American, Alaska Native/Aleut, Hawaiian/Pacific Islander, South African, Brazilian, Swiss, and German populations. 9 , 11 , 15 , 16 , 17 …”

“… 10 Subsequently, Luminex-based genotyping platforms have also been implemented to predict red blood cell phenotypes among patient and donor populations. 11 , 12 , 13 , 14 , 15 Furthermore, matrix-assisted laser desorption/ionisation time of flight mass spectrometry was used to determine blood group alleles in blood donors. 16 , 17 , 18 This method offered high throughput and proved to be less time-consuming than routine serological testing.…”