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Implementing mass‐scale red cell genotyping at a blood center
Author(s) -
Flegel Willy A.,
Gottschall Jerome L.,
Denomme Gregory A.
Publication year - 2015
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.13168
Subject(s) - genotyping , abo blood group system , genotype , antigen , serology , immunology , red blood cell , blood transfusion , biology , whole blood , medicine , genetics , antibody , gene
BACKGROUND When problems with compatibility beyond ABO and D arise, currently transfusion services search their inventories and perform time‐consuming serologic testing to locate antigen‐negative blood. These clinically important blood group antigens can be detected reliably by red cell genotyping, which is a technology whereby DNA‐based techniques are used to evaluate gene polymorphisms that determine the expression of blood group antigens. We introduced mass‐scale genotyping and measured availability of genotyped blood. STUDY DESIGN AND METHODS All non‐Caucasian donors qualified for genotyping along with donors who had a history of repeat donation. Mass‐scale red cell genotyping, performed on an electronic interfaced open array platform, was implemented to screen blood donors for 32 single‐nucleotide polymorphisms that predicted 42 blood group antigens. Genotype screening results were confirmed by phenotyping, when needed for antigen‐negative transfusion, before release of the red blood cell (RBC) unit. RESULTS Approximately 22,000 donors were red cell genotyped within 4 months and a total of 43,066 donors in 4 years. There were 463 discordances (0.52% of 89,596 genotypes with a phenotype). Among the 307 resolved discordances, approximate equal numbers represented historical serologic or genotyping discrepancies (n = 151 and n = 156, respectively). In the final year of the study, a mean of 29% of the daily inventory had a genotype. CONCLUSIONS Red cell genotyping of blood donors using an electronic interface created a large and stable supply of RBC units with historical genotypes. The database served the needs of antigen‐negative blood requests for a large regional blood center and allowed us to abandon screening by serology.