Applying molecular immunohematology discoveries to standards of practice in blood banks: now is the time

Abstract

Lessons from more than 100 years of immunohematology exemplify that many critical discoveries were made serendipitously and their more rapid implementation could have benefited transfusion recipients and pregnancies. Constituents of blood that are not essential for the attempted therapeutic benefit of a transfusion are largely removed from today's blood products. We are now moving on to avoid unnecessary exposure to potentially harmful constituents of the therapeutically required cells, like blood group antigens that are foreign to the patient. Cost efficacy needs to be kept in mind but may eventually prove much better than anticipated, once hidden benefits are captured, as we show by examples from past immunohematologic developments. Here, we detail clinical applications for molecular immunohematology advances including "dry-matching" that will improve transfusion outcomes and argue for their widespread implementation by rapid timelines through standards of practice.

Multipurpose high-throughput filtering microarrays (HiFi) for DNA and protein assays

“…On the contrary, DNA microarray-based tests were identified as the alternative for bringing multiple blood group typing in blood donation qualification centres (Denomme and Flegel, 2008;Veldhuisen et al, 2009). Most of the already identified blood group antigens are associated to single nucleotide polymorphisms (SNPs) (Daniels, 2005), i.e.…”

Policies and Procedures Related to Testing for Weak D Phenotypes and Administration of Rh Immune Globulin: Results and Recommendations Related to Supplemental Questions in the Comprehensive Transfusion Medicine Survey of the College of American Pathologists

“…17,27,32,[36][37][38][39] Investigators have proposed algorithms based on RHD genotyping as alternatives to the practice of Rh typing patients and blood donors by various serological methods. 17,32,36,[40][41][42] As the first step in a comprehensive review and evaluation of current options for updating policies for weak D testing and administration of Rh immune globulin in women with a weak D phenotype, the CAP TMRC conducted a survey in 2012, repeating the questions of the 1999 survey. The present article summarizes the results of the 2012 survey, compares them with those of the 1999 survey, and comments on the opportunities for updating policies and procedures based on changes that have occurred.…”

Integration of red cell genotyping into the blood supply chain: a population-based study

“…5–7 This prophylactic matching can be accomplished by serologic testing 8,9 or by red cell genotype ‘dry’ matching. 10 …”

“…Several available molecular methods can identify a greater number of antigens than can be determined by any blood group serology. 10,13,14 Red cell genotyping provides an opportunity to integrate antigen testing into other molecular testing of blood donors, 15,16 and has been applied to a limited degree outside of the US for routine typing and labeling of blood since 2002. 17 …”