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Identification of molecular alleles of Kell, Kidd, and Duffy in multi-transfused patients with undetermined phenotypes: An approach to reduce alloimmunization
Dalia Diaa ElDine Salem1, Dina Mohamed Mohamed Habashy1, Heba-TAllah Nader ElSayed2, Doaa Magdy Mohamed3, Ibrahim Youssef1, Heba Mohamed Atif1
1 Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Ain Shams University Hospital, Cairo, Egypt
2 Blood Bank, Ain Shams University Hospital Blood Bank, Cairo, Egypt
3 Assistant Lecturer of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Correspondence Address:
Dalia Diaa ElDine Salem,
Faculty of Medicine, Ain Shams University, El Abasseya Square, Cairo 11566
Egypt
 Source of Support: None, Conflict of Interest: None DOI: 10.4103/ajts.ajts_55_22
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BACKGROUND: In multi-transfused patients, alloimmunization usually interferes with accurate phenotyping of blood group antigens and proper selection of blood components. Therefore, DNA-based blood group typing including minor blood groups such as Kell, Kidd, and Duffy systems can overcome the limitations of serological methods and improves the efficiency of the transfusion process.
AIM OF THE WORK: The goal of this study was to determine the allelic frequencies of genetic polymorphisms in Kell, Kidd, and Duffy genes and to compare red blood cell (RBC) molecular genotyping to serological phenotyping in chronically transfused patients.
STUDY DESIGN AND SUBJECTS AND METHODS: A cross-sectional study was carried out on 100 repeatedly blood-transfused Egyptian patients. Patient samples were subjected to ABO, Rh, Kell, Kidd, and Duffy hemagglutination phenotyping in addition to the identification of Kell (K, k), Kidd (JKa, JKb), and Duffy (Fya, Fyb) polymorphisms by polymerase chain reaction-restriction length polymorphism. Patient samples were also subjected to screening and identification of RBC antibodies.
RESULTS: Serological identification of minor blood groups revealed that in Kidd blood group the most common antigen pattern is JK (a + b−) being 34%, in Duffy FY (a + b−) being 26% and for Kell; 96% were K antigen positive and 92% were K antigen negative. As regards genotyping, the most frequent genotypes of the Kell, Kidd, and Duffy systems were KEL02/KEL02 (98%), JK01/JK02 (42%), and FY02/FY02 (60%), respectively. The discrepancy between genotyping and phenotyping was also found in 76% of patients in the Kidd system, 92% of patients in Duffy system, and 2% in Kell blood group system.
CONCLUSION: Extended blood group genotyping including Kell, Kidd, and Duffy groups is superior to serological analysis and can be used as a valuable tool to predict definitive blood grouping, especially in alloimmunized multi-transfused patients to select blood units for perfect cross-matching and preventing alloimmunization. |
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