Transfusion medicine and molecular genetic methods

Abstract

Transfusion procedures are always complicated by potential genetic mismatching between donor and recipient. Compatibility is determined by several major antigens, such as the ABO and Rhesus blood groups. Matching for other blood groups (Kell, Kidd, Duffy, and MNS), human platelet antigens, and human leukocyte antigens (HLAs) also contributes toward the successful transfusion outcomes, especially in multitransfused or highly immunized patients. All these antigens of tissue identity are highly polymorphic and thus present great challenges for finding suitable donors for transfusion patients. The ABO blood group and HLA markers are also the determinants of transplant compatibility, and mismatched antigens will cause graft rejection or graft-versus-host disease. Thus, a single and comprehensive registry covering all of the significant transfusion and transplantation antigens is expected to become an important tool in providing an efficient service capable of delivering safe blood and quickly locating matching organs/stem cells. This review article is intended as an accessible guide for physicians who care for transfusion-dependent patients. In particular, it serves to introduce the new molecular screening methods together with the biology of these systems, which underlies the tests.

The Prevalence of Transfusion-transmitted Infections among Blood Donors in Hospital Universiti Sains Malaysia

“…The low prevalence of TTIs in our donor pool could be attributed to effective blood transfusion practices, including donor screening, an effective deferral system, and a policy of unpaid voluntary donation. 5 As recommended by the World Health Organization, 10 we have also targeted low-risk donor groups, especially university students and government workers. In this context, the frequencies of TTI among blood donors at HUSM reported in this study may not reflect the overall prevalence of HBV, HCV, and HIV in the country.…”

“…Blood samples were collected from 9669 voluntary donors registered at the Transfusion Medicine Unit, HUSM, from September 2017 to June 2018. They all fulfilled the criteria for blood donation as described by Saleh et al 5 A total of 6 mL of peripheral venous blood were collected into three blood collection tubes for laboratory analyses. Tube one contained EDTA and was used for ABO and Rhesus blood regrouping.…”

“… 4 These limitations of phenotyping assays have been recently resolved by testing viral DNA in donated blood using the molecular technique nucleic acid testing (NAT). Several blood donation centers have reported that the incidence of transfusion-transmitted HBV, HCV, and HIV infections and the number of discarded blood donation units have been reduced by combined serological and NAT screenings, 3 - 5 and the rate has further decreased with the inclusion of serological confirmatory and NAT discriminatory assays. 3 , 6 - 9 …”

Blood groups in Native Americans: a look beyond ABO and Rh

“…Alloimmunization can lead to hemolytic transfusion reactions (HTRs) and hemolytic diseases of the fetus and newborn (HDFNs) ( Alves et al, 2012 ). These adverse effects occur more frequently when blood donor recipients or parents of a child differ in their genetic makeup as a result of diverse ethnicities ( Kenny, 2006 ; Saleh et al, 2018 ). ABO and Rh are the most important blood group systems in transfusional medicine; however, other clinically significant systems are worthy of consideration, such as the Kell, Duffy, Diego and Kidd blood systems ( Westhoff, 2019 ).…”

Human Platelet Antigen Datasets for Malays, Chinese, and Indians in Peninsular Malaysia

“…Human platelet antigens (HPAs) are genetically inherited polymorphic glycoproteins expressed on the platelet membrane [ 1 ]. HPAs are transfusion and gestation compatibility determinants, and HPA alloantibodies have been reported in post-transfusion purpura, platelet transfusion refractoriness, and neonatal alloimmune thrombocytopenia (NAIT) cases [ 2 ].…”