Transfusion Support of Minority Patients: Extended Antigen Donor Typing and Recruitment of Minority Blood Donors

Background: The provision of compatible blood products to patients is the most essential task of transfusion medicine. Besides ABO and Rh, a number of additional blood group antigens often have to be considered for the blood supply of immunized or chronically transfused patients. It also applies for platelet antigens (HPA) and neutrophil antigens (HNA) for patients receiving platelet or granulocyte concentrates. Here, we describe the molecular screening for a number of blood group, HPA, and HNA alleles. Based on the screening results we are building up a regional blood donor registry to provide extended matched blood products on demand. Methods: We developed and validated TaqMan™ PCR and PCR-SSP methods for genetic markers defining 37 clinically relevant blood group antigens (beyond ABO and Rh), 10 HPA, and 11 HNA. Furthermore, we describe a feasible method for fast molecular screening of the HNA-2^null phenotype. All data were statistically evaluated regarding genotype distribution. Allele frequencies were compared to ExAC data from non-Finnish Europeans. Results: Up to now more than 2,000 non-selected regular blood donors in south-west Germany have been screened for blood group, HPA, and HNA alleles. The screening results were confirmed by serology and PCR-SSP methods for selected numbers of samples. The allele frequencies were similar to non-finnish Europeans in the ExAC database except for the alleles encoding the S, HPA-3b and HNA-4b antigens, with significantly lower prevalence in our cohort, as well as the LU14 and the HNA-3b antigens, with a higher frequency compared to the ExAC data. We identified 71 donors with rare blood groups such as Lu(a+b-), Kp(a+b-), Fy(a-b-) and Vel-, and 169 donors with less prevalent HPA or HNA types. Conclusion: Molecular screening for blood group alleles by using TaqMan™ PCR is an effective and reliable high-throughput method for establishing a rare donor registry.

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“…Similar concepts for the extended matched blood supply are established in different countries worldwide [34,35,36,37]. …”

Section: Discussionmentioning

confidence: 99%

Towards a Regional Registry of Extended Typed Blood Donors: Molecular Typing for Blood Group, Platelet and Granulocyte Antigens

Portegys

Rink

Bloos

et al. 2018

Transfus Med Hemother

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“…Many hospital transfusion services have implemented policies for the prophylactic provision of antigen‐matched RBCs to their patients with SCD to reduce alloimmunization 33 . Yet again, this presents unique challenges to BC facilities to provide RBCs that are phenotypically matched, largely because of genetic differences between the donor population (predominantly of European descent) vs patients with SCD (predominantly of African or Mediterranean descent) 34 . Chronically transfused patients with β‐thalassemia (predominantly of Mediterranean or Asian descent) also have high rates of alloimmunization, presenting additional challenges to provide compatible RBCs 35 .…”

Section: Donationmentioning

confidence: 99%

Maintaining adequate donations and a sustainable blood supply: Lessons learned

et al. 2020

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Background The availability of a safe blood supply is a key component of transfusion medicine. A decade of decreased blood use, decreased payment for products, and a dwindling donor base have placed the sustainability of the US blood supply at risk. Study Design and Methods A literature review was performed for blood center (BC) and hospital disaster management, chronically transfusion‐dependent diseases, and appropriate use of group O‐negative red blood cells (RBCs), and the Choosing Wisely campaign. The aim was to identify current practice and to make recommendations for BC and hospital actions. Results While BCs are better prepared to handle disasters than after the 9/11 attacks, messaging to the public remains difficult, as donors often do not realize that blood transfused during a disaster was likely collected before the event. BCs and transfusion services should participate in drafting disaster response plans. Hospitals should maintain inventories adequate for patients in the event supply is disrupted. Providing specialty products for transfusion‐dependent patients can strain collections, lead to increased use of group O RBCs, and create logistical inventory challenges for hospitals. The AABB Choosing Wisely initiative addresses overuse of blood components to optimally use this precious resource. Group O‐negative RBCs should be transfused only to patients who truly need them. Conclusions Collecting and maintaining a blood supply robust enough to handle disasters and transfusion‐dependent patients in need of specialty products is challenging. Collaboration of all parties should help to optimize resources, ensure appropriate collections, improve patient care, and ultimately result in a robust, sustainable blood supply.

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“…20,21 In part, they make it possible to overcome the limitations of serological tests. [22][23][24][25] In immunohematology, molecular methods have become more popular since the 1990s when the genetic background of antigen specificities was first described. 26,27 A single nucleotide variant (SNV) is the most common variation resulting from a change of amino acid in the protein sequence which leads to either the presence or absence of the antigen.…”

Section: Blood Group Genotypingmentioning

confidence: 99%

“…Study results support extended profiling of donors and patients for the best prophylactic antigen matching to prevent alloimmunization. 16,[22][23][24] Literature on the use of NGS for studying blood group antigens shows a picture of rapidly developing technology which may prove highly reliable. The technology is now being validated and upgraded especially in terms of antigens with a complex genetic background or with highly homological regions.…”

Section: Ngs In Blood Group Screeningmentioning

confidence: 99%

<p>Potential of next-generation sequencing to match blood group antigens for transfusion</p>

Orzińska¹,

Guz²,

Brojer³

2019

IJCTM

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A review of the advances in applying next-generation sequencing (NGS) to transfusion medicine for the purpose of genotyping alleles encoding clinically important red blood cell and platelet antigens. NGS data from published studies confirm the possibility of antigen prediction based on sequencing of the whole genome, exome or targeted regions. What remains a challenge, to provide highly accurate NGS genotyping, is the further improvement of bioinformatic solutions for automated interpretation based on publicly accessible and improved reference databases appropriate for NGS methods as well as validation of a method based on the examination of a large number of individuals. There is no doubt, however, as to the future of NGS as a supplementary test used to provide highly compatible blood as well as to reduce the risk of patient's alloimmunization. This is part of personalized medicine.

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Transfusion Support of Minority Patients: Extended Antigen Donor Typing and Recruitment of Minority Blood Donors

Cited by 21 publications

References 33 publications

Towards a Regional Registry of Extended Typed Blood Donors: Molecular Typing for Blood Group, Platelet and Granulocyte Antigens

Towards a Regional Registry of Extended Typed Blood Donors: Molecular Typing for Blood Group, Platelet and Granulocyte Antigens

Maintaining adequate donations and a sustainable blood supply: Lessons learned

<p>Potential of next-generation sequencing to match blood group antigens for transfusion</p>

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