Blood group genotyping in transfusion support for sickle cell disease patients

Author(s)

Daiane Cobianchi da Costa

• Document type: Master's Dissertation
• Press: Campinas, SP.
• Institution: Universidade Estadual de Campinas (UNICAMP). Faculdade de Ciências Médicas
• Defense date: 2011-04-25

Examining board members

Lilian Maria de Castilho; Maria Lourdes Barjas Castro; Dante Mário Langhi Júnior

• Advisor: Lilian Maria de Castilho

Abstract

DNA arrays, with their high-throughput capability are particularly suited for mass screening donors because they permit the simultaneous determination of multiple alleles encoding RBC antigens and can facilitate the provision of more extensively matched blood for patients. Based on this we evaluated the usefulness of DNA array technology to provide a means to precisely genotype match donor blood units to the antigen-negative type of patients with SCD. We searched for compatible units for 283 SCD patients performing extended human erythrocyte antigen (xHEA) typing on the patient samples and on 504 donor samples. The degree of matching was determined at 4 increasingly stringent levels of compatibility. Using a special software, we were able to find 482 compatible donors for Level 1 (ABO, D and 1 Antibody) , 237 for Level 2 (ABO, D, C, c, E, e, K1), 75 for Level 3 (ABO, D, C, c, E, e, K1, Fya, Fyb, Jka, Jkb, S, s, Dia) and 31 for Level 4 (ABO, D, C, c, E, e, K1, Fya, Fyb, Jka, Jkb, S, s, Dia, Lua, Lub, M, N, Doa, Dob, Hy, Joa, k, Jsb). We also investigated antigen-match RBC units with 35 recipients using blood group genotypes at the 4 levels of matching stringency. Units selected were serologically matched to the patients based on their ABO, Rh and K phenotypes and presence of antibody (ies). Twenty-one from 35 SCD patients presented discrepancies or mismatches for multiple antigens between their xHEA antigen profile and the blood units antigen profile serologically matched for them. According to these results we were able to find a better match for the patients in our extended HEA (xHEA)-typed units, and in the majority of cases the degree of matching was enhanced and the patients benefit to receive the transfusions as shown by better in vivo RBCs survival. DNA array based blood grouping typing of donors and patients showed to be a cost-effective procedure and has demonstrated improvements in SCD patients care facilitating their transfusion support and preventing the alloimmunization and hemolytic transfusion reactions (AU)

• FAPESP's process: 08/07544-8 - BLOOD GROUP GENOTYPING CAN CONTRIBUTE TO THE TRANSFUSION SUPPORT WITH ANTIGEN-MATCHED BLOOD IN SICKLE CELL DISEASE PATIENTS
• Grantee: Daiane Cobianchi da Costa
• Support Opportunities: Scholarships in Brazil - Master