Will Genotyping Replace Serology in Future Routine Blood Grouping? – Opinion 4

The core question of this forum addresses whether genotyp- ing will replace serology in future routine blood grouping. Our response to that question is another: will genotyping need to replace serology? The past two decades in transfu- sion medicine have witnessed development in two different directions: the older path is one of developing a 'universal' blood supply where all blood is somehow converted to an inert group-O-like status. The Holy Grail is to eliminate pre- transfusion testing, permit the transfusion of any unit of blood to any person and to prevent possible post-transfusion ABO- related haemolytic events. The more recent path leads in the opposite direction, i.e. development of more comprehensive genotyping platforms so that patient and blood donor may be matched specifically for as many antigens as possible and thus limit allo-immunisation events through antigen compatibility. This mimics our current testing practices although on a more grandiose scale and answers the primary forum question with a probable yes, since discrimination at the molecular level is much more comprehensive than that which can be achieved serologically.