Extended blood group phenotyping of donors from the lower and middle Himalayan region of Uttarakhand India: A pilot study.

Abstract

The state of Uttarakhand, bordering countries such as Tibet and Nepal, is a multi-ethnic region. Further, erythrocyte alloimmunization may arise from the incompatibility of major and/or minor blood groups between ethnically diverse donors and recipients. We aimed to screen Uttarakhand blood donors (UBDs) for extended phenotyping of their erythrocytes serologically. This prospective cross-sectional analysis involved all UBD samples collected at the blood centre of our tertiary-care hospital. Samples were obtained over 9months (Mar'22 to Nov'22). Donors who were O-typed, DAT-negative and non-reactive for TTI markers were processed further for serological testing using the column agglutination technique utilizing 21 different monoclonal antisera (Ortho diagnostics Pvt ltd, Mumbai India). The research was financially aided by UCOST, Uttarakhand, Government of India. Of the 5,407 blood samples collected, the total number of O-typed samples collected was 1622. Of these 1622, 329 (20.2%) O-typed samples were selected based on our inclusion criteria and hence further phenotyped. Amongst these 329 UBDs, the average age was 32.7±9.32 (18-52) years and the male-to-female ratio was (M: F=12:1). The prevalence of high- and low-frequency blood antigens in our study was Rh (D 96.6%, C 84.8%, c 63.5%, E 27.9% and e 92%), Lewis (Lea 6.3%, Leb 31.9%), Kidd (Jka 87.8%, Jkb 63.2%), Kell (K 1.8%, k 96.3%) and Duffy (Fya 63.5%, Fyb 10.6%). And in the MNS system we received 21.2% as M, 10.9% N, 37% S and 51.3% as s respectively. We also identified some very rare minor antigens such as Dia 1.8%, Ina 1.8%, Cw 0.6% and, 1.2% Mur positive donors, which are not common in our population, as per the published literature. Moreover, we also identified one Bombay blood phenotype (Oh) in one of our UBD recruits. To sum up, practically with the outcome of this research, we were also able to identify rare phenotypes among the local people and a rare blood donor registry was created. This repository shall also come in use for our multi-transfused patients having different oncological and haematological ailments.