Molecular blood typing augments serologic testing and allows for enhanced matching of red blood cells for transfusion in patients with sickle cell disease
Article first published online: 9 AUG 2011
© 2012 American Association of Blood Banks
Volume 52, Issue 2, pages 381–388, February 2012
How to Cite
Wilkinson, K., Harris, S., Gaur, P., Haile, A., Armour, R., Teramura, G. and Delaney, M. (2012), Molecular blood typing augments serologic testing and allows for enhanced matching of red blood cells for transfusion in patients with sickle cell disease. Transfusion, 52: 381–388. doi: 10.1111/j.1537-2995.2011.03288.x
- Issue published online: 12 JAN 2012
- Article first published online: 9 AUG 2011
- Received for publication March 21, 2011; revision received June 13, 2011, and accepted June 14, 2011.
BACKGROUND: Sickle cell disease (SCD) patients have dissimilar red blood cell (RBC) phenotypes compared to the primarily Caucasian blood donor base due, in part, to underlying complex Rh and silenced Duffy expression. Gene array–based technology offers high-throughput antigen typing of blood donors and can identify patients with altered genotypes. The purpose of the study was to ascertain if RBC components drawn from predominantly Caucasian donors could provide highly antigen-matched products for molecularly typed SCD patients.
STUDY DESIGN AND METHODS: SCD patients were genotyped by a molecular array (HEA Beadchip, BioArray Solutions). The extended antigen phenotype (C, c, E, e, K, k, Jka, Jkb, Fya, Fyb, S, s) was used to query the inventory using different matching algorithms; the resulting number of products was recorded.
RESULTS: A mean of 96.2 RBC products was available for each patient at basic-level, 34 at mid-level, and 16.3 at high-level stringency. The number of negative antigens correlated negatively with the number of available products. The Duffy silencing mutation in the promoter region (67T>C) (GATA) was found in 96.5% of patients. Allowing Fy(b+) products for patients with GATA increased the number of available products by up to 180%, although it does not ensure prevention of Duffy antibodies in all patients.
CONCLUSIONS: This feasibility study provides evidence that centers with primarily Caucasian donors may be able to provide highly antigen-matched products. Knowledge of the GATA status expands the inventory of antigen-matched products. Further work is needed to determine the most clinically appropriate match level for SCD patients.