Molecular testing in transfusion medicine

Wagner, Franz F.

doi:10.1517/17530059.2010.506509

Cited by 8 publications

(7 citation statements)

References 115 publications

(97 reference statements)

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“…A few reports have shown that genotyping is more accurate than phenotyping, and the outcome of a genotyping error (e.g. Jk null) would predict an antigen‐positive unit, which would not harm the patient (Wagner, ). On the other hand, phenotyping errors are relatively common for the Fyb and U antigens.…”

Section: The Future Of Genotype Dry Matchingmentioning

confidence: 99%

Prospects for the provision of genotyped blood for transfusion

Denomme

2013

Br J Haematol

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Summary Blood group genotyping is gaining widespread adoption in blood centres and transfusion services. The current interest for a blood centre is its use as a screening tool to accurately predict donor phenotypes. However, not only is blood group genotyping used to screen for uncommon and rare types on a mass‐scale, it can be used to optimize the inventory of multiple antigen‐negative screened units. In addition, blood group genotyping provides blood types when antisera are not available, it can predict weak and variant antigens, and can aid in the resolution of ABO discrepancies. There are quality improvement benefits in blood group genotyping because it can screen for RHD alleles in Rh‐negative blood donors and can be used to confirm that donors are suitable for reagent red cell production. It is possible that blood group genotyping information may be used as a donor recruitment tool. Given that genotyping can convey much more information about the expression of some complex antigens, e.g. hrB, Uvar, and Duffy, clinical trials are probably needed to show that genotyped or ‘dry matched’ transfusions are superior to phenotyped blood.

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Section: The Future Of Genotype Dry Matchingmentioning

confidence: 99%

Prospects for the provision of genotyped blood for transfusion

Denomme

2013

Br J Haematol

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“…Highly accurate platforms are the best fit for red cell genotyping of patients in elective situations; they can be licensed as tests of record but tend to be elaborate and low throughput (Avent et al , 2009, Hashmi et al , 2005). For mass scale donor typing, the largest datasets were established using methods optimized for low cost and high throughput screening, correcting for inaccuracies by targeted serological checks (Flegel et al , 2015b, Wagner 2010, Perreault et al , 2009). For patients with urgent transfusion needs, we reasoned that the decisive feature was turnaround time (Flegel et al , 2015a).…”

Section: Discussionmentioning

confidence: 99%

“…Molecular immunohematology methods are increasingly used to determine blood group antigens in routine patient care. Established first line indications for red cell genotyping include prenatal diagnosis, such as the prediction of the fetus' phenotype from the mother's peripheral blood; blood group phenotypes that cannot be discriminated by serology; and blood group typing in recipients of massive or chronic transfusions (Denomme & Flegel, 2008;Wagner, 2010). Direct polymerase chain reaction (PCR) has been applied to blood donor typing using heat-treated plasma samples without DNA isolation (Silvy et al, 2015), a simple but not rapid procedure.…”

Section: Discussionmentioning

confidence: 99%

“…These serological results are generally very reliable in donors and patients, if not the recently transfused (Rujirojindakul and Flegel 2014). In contrast, current molecular methods (Wagner 2010) usually take several hours if the time required for DNA isolation and data analysis is properly considered. Often samples have to be transferred to a different laboratory, incurring additional delays until the results become available.…”

Section: Introductionmentioning

confidence: 99%

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Molecular typing for blood group antigens within 40 min by direct polymerase chain reaction from plasma or serum

et al. 2016

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Determining blood group antigens by serological methods may be unreliable in certain situations, such as in patients after chronic or massive transfusion. Red cell genotyping offers a complementary approach, but current methods may take much longer than conventional serological typing, limiting their utility in urgent situations. To narrow this gap, we devised a rapid method using direct polymerase chain reaction (PCR) amplification while avoiding the DNA extraction step. DNA was amplified by PCR directly from plasma or serum of blood donors followed by a melting curve analysis in a capillary rapid-cycle PCR assay. We evaluated the single nucleotide polymorphisms underlying the clinically relevant Fya, Fyb, Jka and Jkb antigens, with our analysis being completed within 40 min of receiving a plasma or serum sample. The positive predictive value was 100% and the negative predictive value at least 84%. Direct PCR with melting point analysis allowed faster red cell genotyping to predict blood group antigens than any previous molecular method. Our assay may be used as a screening tool with subsequent confirmatory testing, within the limitations of the false-negative rate. With fast turnaround times, the rapid-cycle PCR assay may eventually be developed and applied to red cell genotyping in the hospital setting.

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“…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 …”

Section: Introductionmentioning

confidence: 99%

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

Flegel

Gottschall

Denomme

2015

The Lancet Haematology

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Background When problems with compatibility arise, transfusion services often perform time-consuming serologic testing to locate antigen-negative red cell units for safe transfusion. New technologies enabled red cell genotyping for all clinically relevant blood group antigens. We performed mass-scale genotyping and provided access to a large red cell database to meet the demand for antigen-negative red cell units beyond ABO and Rh. Methods A red cell genotype database was established in 2010. Hospitals were given online access to a web-based antigen query portal in 2013 to find antigen-negative units in their inventories. Findings Genotype data were analyzed for 43,066 blood donors covering a set of 42 clinically relevant red cell antigens. Requests were filled for 5661 of 5672 patient encounters (99.8%) requiring antigen-negative red cell units in a multi-ethnic and multi-racial population. Red cell genotyping met the demand for antigen-negative blood in 5339 of 5672 (95%) patient encounters, while 333 remaining requests were filled using serologic data. In a pilot phase, seven community and rural transfusion services searched their local inventories using an online antigen query portal. Interpretation Red cell genotyping has the potential to transform the way antigen-negative red cell units are provided. An antigen query portal may reduce the need to ship blood or perform serologic screening. The wealth of genotype data, easily accessible online, facilitates the supply of affordable antigen-negative red cell units for patient safety. Physicians may recognize these new efficiencies for patient transfusion support. Funding BloodCenter of Wisconsin Diagnostic Laboratories Strategic Initiative and the NIH Clinical Center Intramural Research Program.

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Molecular testing in transfusion medicine

Abstract: At present, molecular methods complement serologic antigen determination and are an invaluable tool for specific diagnostic problems. Mass-scale molecular antigen prediction of blood donors is beginning to improve blood supply for specific patient groups.

Cited by 8 publications

References 115 publications

Prospects for the provision of genotyped blood for transfusion

Prospects for the provision of genotyped blood for transfusion

Molecular typing for blood group antigens within 40 min by direct polymerase chain reaction from plasma or serum

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

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