Extended Phenotyping to Identify Blood Donors for an Institutional Rare Donor Registry

Abstract

Abstract Background: Alloantibody formation to red cell antigens, sometimes seen in patients receiving multiple transfusions, are capable of causing hemolytic transfusion reactions when transfused with blood cells that are positive for the corresponding antigens. Providing them with red cells negative to these antigens becomes imperative. There is a need to have a pool of donors known to be negative for such antigens to provide blood units to such patients. Aim: The aim of the study is to identify rare donors in our population and register them for need-based blood unit collection for patients when phenotype-specific blood units are required. Methodology: Regular blood donors after consent were included for extended phenotyping for antigens c, C, e, E, K, k, Lea, Leb, Lua, Lub, P1, Kpa, Kpb, Jka, JKb, M, N, S, s, Fya, and Fyb by serological testing using monoclonal antisera. The phenotypes that were either negative for high-frequency antigens such as H, k, or multiple common antigen negative phenotypes were identified and enrolled as rare blood donors. Results: A total of 202 donors were completely phenotyped for the said 21 antigens. We identified 14 such donors, 7 of whom were high-frequency antigen-negative and 7 were multiple common antigen-negative phenotypes. The turnaround time for providing blood for patients requiring such units has drastically reduced with this initiative. A unit of such a rare phenotype was collected and shipped to Pune for a patient who required it within 24 h. Conclusion: Our findings highlight the need for a countrywide rare donor registry to coalesce the data from all centers with the facility for phenotyping. This will reduce the turnaround time of searching for donors for a particular phenotype, contributing to better patient care, and emergency management.