DNA-based methods in the immunohematology reference laboratory

Abstract

Although hemagglutination serves the immunohematology reference laboratory well, when used alone, it has limited capability to resolve complex problems. This overview discusses how molecular approaches can be used in the immunohematology reference laboratory. In order to apply molecular approaches to immunohematology, knowledge of genes, DNA-based methods, and the molecular bases of blood groups are required. When applied correctly, DNA-based methods can predict blood groups to resolve ABO/Rh discrepancies, identify variant alleles, and screen donors for antigen-negative units. DNA-based testing in immunohematology is a valuable tool used to resolve blood group incompatibilities and to support patients in their transfusion needs.

High prevalence of red blood cell alloimmunization in sickle cell disease despite transfusion from Rh-matched minority donors

“…8,10,12,16 Transfusion with units from African American donors has also been suggested, 9,10 although an increase in production of antibodies to low incidence antigens present primarily in minority groups is predicted. 17 Phenotype matching for additional minor antigens in the Kidd, Duffy, and MNS systems reveal that more stringent matching results in lower alloimmunization rates, 6,18 but there is no standard of practice. 19 The Rh system is a complex blood group system and includes .50 different serologic specificities.…”

ABO in the Context of Blood Transfusion and Beyond

“…But still, there are cases in which mutations in non-coding regions can produce aberrant messengers, as the formation of a new splicing site, or changes in expression levels if they are located in promoter or enhancer regions. Confusion over non-deleterious SNPs and novel mutations is going to arise with the introduction of these new technologies, and therefore forward and/or reverse typing are not going to disappear from blood bank facilities (Anstee, 2009;Reid & Denomme 2011).…”

Clinical Potential of Effective Noninvasive Exclusion of <b><i>KEL1</i></b>-Positive Fetuses in <b><i>KEL1</i></b>-Negative Pregnant Women

“…The difference in the gene sequence between the KEL1 and KEL2 alleles is caused by a single nucleotide substitution in exon 6 at position 578 (c.578C>T, rs8176058); the presence of T characterizes the KEL1 allele and the presence of C characterizes the KEL2 allele [4,5]. The single nucleotide change 578C>T results in the substitution of threonine (‘k') to methionine (‘K') at position 193 (p.Thr193Met) [6,7].…”