Partial matching of blood group antigens to reduce alloimmunization in Western India

Gogri, Harita; Kulkarni, Shrikant; Vasantha, K; Jadhav, Seema; Ghosh, Kanjaksha; Gorakshakar, Ajit

doi:10.1016/j.transci.2016.02.002

Cited by 8 publications

(7 citation statements)

References 27 publications

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“…The most commonly encountered alloantibodies are produced against the common blood group antigens of Rh, Duffy, Kell and Kidd systems. However, an Indian study reported that after Rh, antibodies against MNS blood group antigens were the most commonly encountered8. Hence, in the present study, multitransfused thalassaemic patients were genotyped for clinically important blood group antigens of Rh, Kell, Kidd, Duffy and MNS blood group antigens using DNA-based method and the results were compared with the serological typing results.…”

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confidence: 98%

Molecular genotyping of clinically important blood group antigens in patients with thalassaemia

Kulkarni¹,

Choudhary²,

Gogri³

et al. 2018

Indian J Med Res

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Background & objectives: In multitransfused thalassaemic patients, haemagglutination fails to phenotype the patient's blood group antigens due to the presence of donor-derived erythrocytes. DNA-based methods can overcome the limitations of haemagglutination and can be used to determine the correct antigen profile of these patients. This will facilitate the procurement of antigen-matched blood for transfusion to multitransfused patients. Thus, the aim of this study was to compare the serological phenotyping of common and clinically important antigens of Rh, Duffy, Kell, Kidd and MNS blood group systems with molecular genotyping amongst multitransfused thalassaemic patients. Methods: Blood samples from 200 patients with thalassaemia and 100 ‘O’ group regular blood donors were tested using standard serological techniques and polymerase chain reaction-based methods for common antigens/alleles (C, c, D, E, e, Fy a , Fy b , Jk a , Jk b , K, k, M, N, S, s). Results: Genotyping and phenotyping results were discordant in 77 per cent of thalassaemic patients for five pairs of antithetical antigens of Rh, Duffy, Kell and Kidd blood group systems. In the MNS blood group system, 59.1 per cent of patients showed discrepancy. The rate of alloimmunization among thalassaemics was 7.5 per cent. Interpretation & conclusions: Molecular genotyping enabled the determination of the actual antigen profile in multitransfused thalassaemia patients. This would help reduce the problem of alloimmunization in such patients and would also aid in the better management of transfusion therapy.

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confidence: 98%

Molecular genotyping of clinically important blood group antigens in patients with thalassaemia

Kulkarni¹,

Choudhary²,

Gogri³

et al. 2018

Indian J Med Res

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“…[25][26][27][28] A study from India, however, did not find routine transfusion of Rh and Kell phenotype-matched blood to all patients beneficial. 29 The authors concluded that the majority of the patients were non-responders; thus, provision of Rh and Kell phenotypematched units only to hematopoietic progenitor cell transplant recipients seems the best option for a country like ours. The authors also noted that anti-K was the third most common antibody after anti-D and anti-E. Alloimmunization to K has been well studied in pregnant women and other patient categories, especially thalassemia patients.…”

Section: Discussionmentioning

confidence: 80%

A prospective, observational study for optimization of antibody screening in pretransfusion compatibility testing

et al. 2020

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Despite known use of antibody screening (AS), it has not been adopted uniformly across blood centers in India. Many centers in India are currently using a type and hold policy with subsequent antihuman globulin (AHG) crossmatch when blood units are requested. The main aim of this study was to assess the benefits of a type and screen (TS) policy in which blood grouping and AS are performed simultaneously during the first hospital visit. If the AS is negative, subsequent requests for blood units would require an immediate spin test (IST) crossmatch with release of blood units, followed by an AHG crossmatch. This prospective, observational study was conducted at a tertiary health care center between July 2014 and December 2018 and included only Indian patients. Blood grouping and AS were performed during the first hospital visit on a total of 22,888 patients; the majority of patients were from hemato-oncology and blood marrow transplant, hepatology and liver transplant, cardiothoracic vascular surgery, and medical intensive care units. Demographic parameters were evaluated for risk of alloimmunization, and a record of the same was maintained. Depending on the AS results, a further course of action was chosen. Clinically significant alloantibodies were detected in 145 patients, and autoantibodies were detected in 53 patients. Alloantibodies were mainly against Rh and Kell blood group antigens. A significantly higher proportion of patients in the AS+ group required blood transfusion when compared with the AS– group. In cases wherein the IST crossmatch was compatible but AHG crossmatch was not, follow-up did not demonstrate any clinical or laboratory evidence of hemolysis. AS is a safe, efficient, and beneficial tool for pretransfusion compatibility testing in both AS+ and AS– patients. With a TS policy, AHG crossmatch can be omitted in AS–e patients without compromising safety.

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“…The MDmulticard Basic Extended Phenotype might become an equal or even superior alternative for such purposes. Moreover, the MDmulticard system could not only be adequate for blood typing in emergency situations [4,8,9,10] and extreme environment conditions [22], but could also be more cost-effective, as it limits the number of genotyping investigations necessary (and therefore the costs) to provide antigen-matched blood, especially for patients with autoantibodies or sickle cell disease. However, this should be confirmed by studies specifically aimed to cost and time analyses [23].…”

Section: Discussionmentioning

confidence: 99%

“…Even in a transfusion emergency, extending phenotype matching to antigens in addition to ABO, Rh and K would be beneficial in reducing alloimmunization [8,9,10]. With this aim, the new MDmulticard Basic Extended Phenotype is intended to perform a basic extended phenotype covering additional clinically significant antigens: Duffy (Fy a , Fy b ), Kidd (Jk a , Jk b ), and Ss antigens (S, s) [11].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the New Lateral Flow Card MDmulticard® Basic Extended Phenotype in Routine Clinical Practice

Mayer

Müller

Candela-García

et al. 2018

Transfus Med Hemother

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Background: Transfusion emergencies and critical situations require specifically designed devices to simplify and optimize the standard procedures. In addition, matching antigens over and above ABO-Rh-K would be beneficial. Methods: Routine blood samples were collected in four immunohematology centers and tested with the new MDmulticard Basic Extended Phenotype for the simultaneous detection of the Duffy, Kidd, and Ss antigens, according to the principle of the lateral flow. Results were compared with those obtained using routine serology methods. Discrepancies were analyzed by molecular techniques/genotyping. Results: 310 samples were tested (167 donors; 75 patients; 28 subjects with positive direct antiglobulin test (DAT); 15 newborns; 25 previously transfused patients). The 285 samples with non-mixed-field reaction yielded 1,710 antigen results with 8 discrepancies (0.47%) six of which in DAT-positive subjects: three false-positive (Fy^a) for MDmulticard, and two false-positive (Fy^a) plus three false-negative (Fy^b) for the reference methods (MDmulticard PPA for donors/patients/newborns: 99.82%; negative percent agreement: 100%; sensitivity: 100%; specificity: 99.39%, positive predictive value: 99.75%; negative predictive value: 100%). The MDmulticard detected mixed-field in 15 antigen reactions from 13 transfused patients, undetected by the comparative method, with the opposite result in 8 antigens (5 patients). Conclusion: The MDmulticard Basic Extended Phenotype met the criteria prescribed for the testing of donor, patient, DAT-positive, and newborn samples in transfusion laboratory routine.

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Partial matching of blood group antigens to reduce alloimmunization in Western India

Cited by 8 publications

References 27 publications

Molecular genotyping of clinically important blood group antigens in patients with thalassaemia

Molecular genotyping of clinically important blood group antigens in patients with thalassaemia

A prospective, observational study for optimization of antibody screening in pretransfusion compatibility testing

Evaluation of the New Lateral Flow Card MDmulticard® Basic Extended Phenotype in Routine Clinical Practice

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