BackgroundThe Kell blood group system expresses high and low frequency antigens with the
most important in relation to transfusion including the antithetic KEL1 and KEL2;
KEL3 and KEL4; KEL6 and KEL7 antigens. Kell is a clinically relevant system, as it
is highly immunogenic and anti-KEL antibodies are associated with hemolytic
transfusion reactions and hemolytic disease of the fetus and newborn. Although
required in some situations, Kell antigen phenotyping is restricted due to
technical limitations. In these cases, molecular approaches maybe a solution. This
study proposes three polymerase chain reaction genotyping protocols to analyze the
single nucleotide polymorphisms responsible for six Kell antithetic antigens
expressed in a Brazilian population. MethodsDNA was extracted from 800 blood donor samples and three polymerase chain
reaction-restriction fragment length polymorphism protocols were used to genotype
the KEL*1/KEL*2, KEL*3/KEL*4 and KEL*6/KEL*7 alleles. KEL*3/KEL*4 and KEL*6/KEL*7
genotyping was standardized using the NlaIII and MnlI restriction enzymes and
validated using sequencing. KEL*1/KEL*2 genotyping was performed using a
previously reported assay. ResultsKEL genotyping was successfully implemented in the service; the following
distribution of KEL alleles was obtained for a population from southeastern
Brazil: KEL*1 (2.2%), KEL*2 (97.8%), KEL*3 (0.69%), KEL*4 (99.31%), KEL*6 (2.69%)
and KEL*7 (97.31%). Additionally, two individuals with rare genotypes, KEL*1/KEL*1
and KEL*3/KEL*3, were identified. ConclusionKEL allele genotyping using these methods proved to be reliable and applicable to
predict Kell antigen expressions in a Brazilian cohort. This easy and efficient
strategy can be employed to provide safer transfusions and to help in rare donor
screening.