ABO Blood Group Research Articles

IMMUNOLOGICAL REACTIVITY AND REACTIVE RESPONSE OF PERIPHERAL BLOOD NEUTROPHILIC GRANULOCYTES IN PATIENTS WITH COVID-19 DEPENDING ON THEIR BLOOD GROUP

At the onset of the Coronavirus Disease 2019 (COVID-19) pandemic, a potential link between ABO blood type and susceptibility to the disease was reported. The evidence supporting this link is strengthening as the volume and quality of research expand. Recently, interest has shifted from merely examining susceptibility to exploring the severity of the disease and the immune response characteristics of patients in relation to their blood groups. Objective: to investigate the immunological reactivity and reactive response of peripheral blood neutrophilic granulocytes in patients with COVID-19 patients based on their blood group. Materials and methods. This prospective study included 198 patients with COVID-19-associated pneumonia of mild, moderate, and severe degrees. The cohort comprised 50.51% (100) men and 49.49% (98) women, with an average age of 54.18 ± 7.25 years (range: 18 to 80 years). The distribution of blood groups according to the ABO system was as follows: 0 (I) - 37.37% (74 patients), A (II) - 37.37% (74 patients), B (III) - 18.18% (36 patients), and AB (IV) - 7.07% (14 patients). The immunological reactivity and reactive response of neutrophilic granulocytes were assessed through the analysis of 14 integral leukocyte indices, including the leukocyte shift index, the ratio of the absolute number of leukocytes to the erythrocyte sedimentation rate (ESR), the lymphocyte-granulocyte index, the lymphocyte index, the index of immunological resistance, and reactivity, among others. Results. In moderate and severe coronavirus infection, the indices of cellular and total immune reactivity and resistance are significantly lower compared to mild coronavirus infection: 1.35-3.08 times (p≤0.042-0.001) for resistance, 2.02-3.87 times (p<0.001) for reactivity, respectively, showing the highest activity among them in the owners of blood group 0 (I), with significantly lower values for A (Ⅱ), B (Ⅲ) and AB (Ⅳ) group variants by 3.94-19.10%. Whereas, with increasing severity of the disease, the reactive response of neutrophilic granulocytes, on the contrary, increases significantly compared to the mild degree: in moderate disease by 43.79-87.62% (p≤0.018-0.005), in severe disease by 1.62-2.11 times (p≤0.012-0.001), with the highest average value in AB (Ⅳ) blood group owners – by 46.69-68.44% (p≤0.017-0.005). Conclusions. The highest index of immunological reactivity is observed in individuals with blood group AB (IV) experiencing a mild clinical course of the disease. Conversely, the lowest index of immunological reactivity is found in patients with blood group A (II) who have a moderate clinical course. Additionally, the reactive response of neutrophilic granulocytes significantly increases in patients with a severe clinical course, with the highest average value recorded in those with blood group AB (IV).

The relics of Jesus and Eucharistic miracles: scientific analysis of shared AB blood type

The relics of Jesus and Eucharistic miracles: scientific analysis of shared AB blood type

An investigation into the contributing factors to survival of ARDS patients supported by veno-venous ECMO.

This study aimed to identify characteristics associated with survival during and post Extra Corporeal Membrane Oxygenation (ECMO) therapy, in patients with acute respiratory distress syndrome (ARDS) during the COVID-19 pandemic. A retrospective observational study on 94 consecutive patients with confirmed COVID-19 induced ARDS supported by ECMO was carried out 49/94 (52.7%) patients survived to hospital discharge. Non-survivors were found to have significantly (p < .05) higher: Pre-ECMO International normalized ratios (INR), carbon dioxide partial pressure (pCO2), Acute Kidney Injury (AKI) scores and blood urea levels. Also, lower pre-ECMO peak inspiratory pressures (PIP), mean arterial pressure, saturation of arterial oxygen (SaO2), blood bicarbonate levels (HCO3), blood Ph and fewer trials off ECMO with shorter combined trial off times. Patients that did not survive were more likely to have renal impairment and have received peri-ECMO haemofiltration. Poor prognosis was significantly associated with: receiving pre-ECMO nitric oxide (HR = 3.047, CI = 1.247-7.447, p = .015), renal impairment (HR = 3.023, CI = 1.586-5.763, p < .001), AKI of 2 (HR = 3.611, CI = 1.382-9.441, p = .009) or 3 (HR = 3.275, CI = 1.235-8.685, p = .017), peri-ECMO haemofiltration (HR = 2.412, CI = 1.310-4.442, p = .005) and the ABO blood group B (HR = 3.103, CI = 1.335-7.212, p = .008). pre-ECMO high CO2 (HR = 1.134, CI = 1.031-1.248, p = .010), blood lactate (HR = 1.350, CI = 1.156-1.576, p < .001), INR (HR = 2.571, CI = 1.438-4.598, p=<0.001) and lower blood Ph (HR = 0.023, CI = 0.002-0.210, p < .001). Commonly used mortality scores may not be of use in a COVID-19 cohort of ECMO patients. The initiation of ECMO needs to be implemented prior to metabolic derangements, renal and fulminant respiratory failure.

Association of ABO phenotype, rhesus factor, platelet count and hemoglobin level with oral hygiene status and severity of chronic periodontitis

BackgroundThe development of periodontal diseases has multifactorial causes including genetic factors. Limited investigations have been conducted to explore the association between ABO blood groups and the development and progression of periodontal diseases. AimTo evaluate and assess the association of ABO Phenotype and Rhesus factor with oral hygiene status, severity of chronic periodontitis and blood parameters like hemoglobin level and Platelet count in localized and generalized chronic periodontitis. Material and methodsStudy was carried out on 100 patients, out of which 80 patients of Generalized Chronic Periodontitis and 20 patients of Localized Chronic Periodontitis. Patients were categorized into Mild, Moderate and Severe Periodontitis. ResultA highly significant association was found between severity of periodontitis and blood groups with blood group B and O were found to be at a greater risk to develop moderate to severe form of chronic periodontitis. Also subjects with blood group B and O showed worst oral hygiene among all the blood groups. Also patients suffering from chronic periodontitis showed a general trend towards lower limit of both hemoglobin level and platelet. ConclusionGenetic factors such as ABO blood group antigens may act as a risk influencer that plays a role in progression and severity of the chronic periodontitis, with blood group B and O being worst affected. Another observation was that a long standing case of chronic periodontitis can lead to anemia thus having systemic implications.

Gestational Diabetes Mellitus and its Association with ABO Blood Group Type among Pregnant Women with Pregnancy-Induced Hypertension in Northwest Ethiopia: A Comparative Study

Gestational Diabetes Mellitus and its Association with ABO Blood Group Type among Pregnant Women with Pregnancy-Induced Hypertension in Northwest Ethiopia: A Comparative Study

Maternal-Newborn ABO Blood Groups and Risk of Bacterial Infection in Newborns

Newborn immunity largely relies on maternal-fetal transfer of antibodies in utero. Incongruency in ABO blood groups between a mother and newborn may be associated with protection against serious infections, but data specific to newborn bacterial infections are lacking. To ascertain the association between maternal-newborn ABO blood group incongruence and lower risk of bacterial infection in newborns. This cohort study used linked patient-level datasets for all singleton live births between January 1, 2014, and December 31, 2020, in hospitals and health centers in Ontario, Canada. The cohort comprised maternal-newborn pairs with known ABO blood groups. Data analysis was conducted between February and May 2024. Maternal-newborn ABO blood group incongruence vs congruence. The primary outcome was a bacterial infection arising in newborns within 30 days of birth. Bacterial infection was cultured from either blood, cerebrospinal fluid, urine, or lung specimen. Secondary outcomes were a bacterial infection with 7 days and 90 days of birth. Modified Poisson regression generated adjusted relative risks (ARRs) and 95% CIs, adjusted for neonatal sex and preterm birth. A total of 138 207 maternal-newborn pairs (maternal mean [SD] age, 31.8 [5.1] years among those with ABO blood group incongruency and 31.5 [5.1] years among those with ABO blood group congruency; newborn mean [SD] gestational age, 38.5 [2.3] weeks among those with incongruency and 38.4 [2.5] weeks among those with congruency; 19 475 males [51.3%] with incongruency and 52 041 males [51.9%] with congruency) were analyzed. Of these pairs, 37 953 (27.5%) had ABO blood group incongruency and 100 254 (72.5%) had ABO blood group congruency. Within 30 days of birth, 328 (8.6 per 1000) newborns in the incongruent group and 1029 (10.3 per 1000) newborns in the congruent group experienced a bacterial infection, corresponding to an ARR of 0.91 (95% CI, 0.81-1.03). The ARRs for bacterial infection within 7 days and 90 days of birth were 0.89 (95% CI, 0.73-1.09) and 0.86 (95% CI, 0.78-0.94), respectively. This cohort study found no association between maternal-newborn ABO blood group incongruence and risk of bacterial infection in newborns within 30 and 7 days of birth. However, incongruence was associated with a decreased risk of bacterial infection within 90 days of birth.

Exploring the Link between ABO Blood Groups and Obesity among Young Adults

Objective: To explore the link between the ABO blood groups and obesity among young adults of Hyderabad district, Sind, Pakistan. Methods: This cross-sectional study was conducted from February 2021 to January 2022, and included 582 randomly selected participants, including 301 males and 281 females, aged between 18 to 40 years, from various institutions of district Hyderabad, including students, faculty members, and employee of universities, colleges, hospitals. A simple random sampling technique was used for the collection of data. Before induction, verbal consent was taken from all the participants. Data was collected by a self-structured questionnaire including sociodemographic characteristics. A brief history was taken relevant to the parameters of the study followed by measuring Body Mass Index, waist circumference, and waist-hip ratio. BMI was categorized with South Asian standards. Data collected through structured questionnaires and anthropometric parameters were analyzed by SPSS version 20.0. Results: In this study, the data of 582 participants were included out of 600 participants, as the remaining 18 could not provide complete data. The mean age in male participants was 27.83 ± 5.478 and in females was 22.27 ± 4.730. The average BMI in male participants was 25.81 ± 5.08 and in females was 24.00 ±4.90. Overall, 205 B blood group participants were found obese, which included 111 male participants and 94 female participants, followed by blood 197 group O participants, 130 A blood group participants, and 50 AB group individuals. In total, there were 536 Rh positives, and only 42 Rh negatives. Individuals with blood group B and Rh-positive status were identified at being greater risk of developing higher BMI, waist-hip ratio, and waist circumference. Conclusion: The evidence found in this study proved a positive association of the types of blood groups with BMI, waist-hip ratio, and waist circumference.

ABO blood groups and platelet reactivity in patients with coronary artery disease undergoing percutaneous coronary intervention treated with clopidogrel

Abstract Background The association between ABO blood groups and the risk of thrombosis and bleeding in patients with coronary artery disease has been of interest for many years, but the mechanisms are not fully understood. Aim To investigate the relationship between the ABO blood groups and the platelet reactivity in patients with coronary artery disease undergoing percutaneous coronary intervention (PCI) treated with clopidogrel. Methods We examined 10,724 consecutive PCI patients in China from January 2013 to December 2013.Among them, 6,740 patients had the results of thromborlastogram (TEG) and the ABO blood groups. Low on-treatment platelet reactivity (LTPR) was defined as adenosine diphosphate-induced platelet maximum amplitude of TEG&amp;lt;31mm. Results A total of 6,740 PCI patients (mean age, 58.23±10.27; male, 77.6%) treated with clopidogrel were finally enrolled for analysis. There were 2560 (37.98%) patients in LTPR group. In this group, the multivariate logistic regression showed that the blood group A (OR: 0.885, 95%CI 0.789-0.993, p=0.038) was independent protective factor in the A/non-A model (model 1). Then, we further divided the non-A groups into B, O, AB groups to set the model 2. In model 2, compared to A, multivariate logistic regression showed that only the blood group B (OR: 1.157, 95%CI 1.015-1.320, p=0.030) was independent risk predictors for LTPR, representing a higher risk of bleeding. Conclusions In the large sample real-world study, we reported the relationship between ABO blood groups and platelet reactivityin PCI patients treated with clopidogrel for the first time. Blood group A was an independent protective factor for LTPR, representing a lower risk of bleeding, whereas blood group B was an independent risk factor for LTPR, representing a higher risk of bleeding. These results provide an interesting perspective on blood groups and individualized antithrombotic therapy in patients with coronary artery disease, and further elucidation of the mechanisms is still needed in the future.

ABO Blood Type and Short-Term Mortality in Patients With Infection-Associated Disseminated Intravascular Coagulation.

Disseminated intravascular coagulation (DIC) is a devastating disease of the coagulation system. We examined the association between ABO blood type and short-term mortality in patients with infection-associated DIC. The study cohort was drawn from the Danish Disseminated Intravascular Coagulation (DANDIC)cohort. Our subcohort was restricted to patients with infection-associated DIC. All-cause 30-day and 90-day mortality were computed by Kaplan-Meier estimates and odds ratios between ABO blood types were examined using logistic regression analysis adjusted for age, sex, comorbidity, and location of infection. Blood type O was used as a reference. The DANDIC cohort included 3023 patients with DIC. Among these, 1853 (61%) had infection-associated DIC. Data on ABO blood type were unavailable in 34 patients (1.8%), who were excluded. The median age was 68 years and 58.2% were males. The 30-day mortality ranged between 38.6% and 42.5% and the 30-day mortality odds ratios were 1.15 (95% confidence interval (CI), 0.92-1.42) for blood type A; 0.84 (95% CI, 0.49-1.43) for AB; and 0.95 (95% CI, 0.67-1.33) for B compared to blood type O. We found no clinically meaningful difference in short-term mortality between the various ABO blood types in patients with infection-associated DIC.

Effect of Donor/Recipient ABO Mismatch on Outcome of Allogenic Hematopoietic Stem Cell Transplantation in Children: Single-Center Study

ABO blood group mismatch between donor and recipient is thought to be associated with several immunopharmacological complications but is not considered a major contraindication to allogeneic hematopoietic stem cell transplantation (HSCT). However, the impact of such a mismatch on overall survival, transplant-related mortality, graft-versus-host disease, and time to neutrophil and platelet engraftment seems to be conflicting. This retrospective cohort was carried out on children and adolescents who underwent allogenic HSCT between January 2016 and January 2023. ABO compatibility state was assessed and grouped into compatible, minor, major, and bidirectional incompatible groups. The effect of ABO compatibility on various transplantation outcomes was assessed. Forty-three children (25 males and 18 females) with different diagnoses were included. More than half of the patients had no ABO mismatch. Major ABO mismatch was found to be associated with a higher incidence of acute graft-versus-host-disease (aGVHD), whereas near significantly higher mortality was observed in the minor mismatch group. Otherwise, no association was found between ABO mismatch and platelet or neutrophil engraftment. ABO mismatch does not affect the overall survival or the posttransplant engraftment of patients undergoing allogeneic HSCT. aGVHD was observed to be the only factor affected by ABO compatibility.

Increasing prevalence of galactose-α-1,3-galactose sensitization in the Danish general adult population.

Alpha-gal syndrome is a novel food allergy to the oligosaccharide galactose-α-1,3-galactose (alpha-gal) present in mammalian meat. Tick bites are considered an important route of sensitization to alpha-gal. Data on alpha-gal sensitization in the general population is scant. We utilized a unique data source of repeated population-based health examination studies to assess prevalence, time trends, risk factors, and characteristics of alpha-gal sensitization. Alpha-gal sensitization was assessed in >11.000 adults from four health examination studies of randomly invited residents in the Copenhagen region conducted in 1990-1991, 2011-2012, 2012-2015, and 2016-2017. Alpha-gal sensitization was defined as serum specific IgE (sIgE) to alpha-gal ≥0.1 kUA/L; ≥0.35 kUA/L; ≥0.7 kUA/L; ≥3.5 kUA/L. The population was characterized according to genetically determined ABO blood group, aeroallergen sensitization, and pets at home. The prevalence of sIgE to alpha-gal ≥0.1 kUA/L was 1.3% in 1990-1991, 3.7% in 2012-2015 and 3.2% in 2016-2017. Of those sensitized to alpha-gal >97% reported to consume red meat at least once a week, even for sIgE to alpha-gal ≥3.5 kUA/L. Male sex, older age, aeroallergen sensitization, cat at home, and blood group A were associated with increased odds of alpha-gal sensitization. The known protective effect of blood group B was confirmed. In this general adult population, the prevalence of alpha-gal sensitization had doubled from 1990-1991 to 2016-2017. This could potentially be due to increased tick exposure and an increased atopic predisposition.

Association of ABO blood group with blood pressure in healthy adults of districts Hyderabad Pakistan

BackgroundIncreased blood pressure is called a “silent killer” as it is often asymptomatic and can persist without the knowledge of the sufferer. It is one of the most prevalent and strong predictive factors for cardiovascular diseases.MethodologyThis cross-sectional study was conducted to find out any association of the ABO blood group with blood pressure and includes 581 randomly selected subjects from the different organizations of district Hyderabad including Universities, colleges, Hospitals, their students, faculty members, and their employees. This study was conducted from February 2021 to January 2022. Informed consent was obtained from volunteers. A detailed history was taken followed by a thorough clinical examination. Blood pressure was recorded with a mercury sphygmomanometer in sitting position. Blood grouping was done by ABO typing. Data obtained were analyzed by SPSS version 23.0.ResultsIn this study, the B blood group participants were 205 (34.22%) was found more prevalent in district Hyderabad, the mean systolic blood pressure was 119.10 ± 16.57, and the mean diastolic blood pressure was 78.89 ± 29.85. and in blood group B participants systolic blood pressure was found 46.82% and diastolic blood pressure was found 43.90% also in B blood group participants followed by A, O, and AB.ConclusionThe incidence of hypertension is high in Pakistan as found in other developing countries. In this study, the evidence is suggestive of the association of the B blood group with increased blood pressure in young healthy adults of district Hyderabad Pakistan.

Prevalence of a Subtype in Iraqi Donations of National Blood Transfusion Center

General Background: The ABO blood group system is essential in blood transfusion, with subtypes of A and B groups influencing clinical outcomes. Specific Background: Subtypes A1 and A2 differ in the amount of antigen on red blood cells, impacting blood typing accuracy. Knowledge Gap: The prevalence of A2 and A2B subtypes in Iraqi donors remains underexplored, and their detection in routine screening can be challenging. Aims: This study aimed to determine the prevalence of A2 and A2B subtypes among Iraqi blood donors and evaluate the necessity of Anti-A1 reagent in accurate subtype identification. Results: In 2022, type O blood donors were the most prevalent, followed by B, A, and AB. A routine screening identified 0% A2 and 0.7% A2B subtypes, but 5% and 14.2% were A2B. Novelty: This study highlights the limitations of routine serological testing in detecting A subtypes, demonstrating that the use of Anti-A1 reagent significantly improves accuracy. Implications: Given the low rate of discrepancy between forward and reverse grouping, the Anti-A1 reagent should be routinely used for detecting A subtypes in clinical settings. Additionally, molecular techniques may be required to distinguish between rarer A subtypes such as A3, Ax, and Am. Highlights: ABO subtypes A1 and A2 are vital for precise blood transfusion typing. Routine tests miss A2; Anti-A1 reagent ensures accurate subtype detection. Molecular techniques help identify rarer subtypes like A3 and Ax. Keywords: ABO system, blood subtypes, Iraqi donors, Anti-A1 reagent, blood typing

Peculiarities of the format of genetic blood systems in patients with oral lichen planus

The number of patients with oral lichen planus (OLP) has increased due to the raise of aggressive forms of the disease (erosive, ulcerative and hyperkeratotic forms) with a possible risk of malignancy. There are isolated researches which indicate a genetic determinism to OLP, but more often these conclusions are based on insufficiently adequate and out of date methods, which make it impossible to correctly interpret the obtained data. The aim was to identify a genetical predisposition with a programmed risk to the oral lichen planus. The main group – 278 patients with the OLP (aged 26-65 years). The control group – 298 people (blood donors) who didn’t have dental diseases, as well as diseases of internal organs and systems. The groups were homogeneous by gender and age. In our research we used such methods: clinical, radiological, immunogenetic, statistical methods were used. The erosive form of OLP was associated with 0(I) group in 54.2±0.4% of cases, while the hyperkeratotic form was associated with group 0(I) only in 28.7±1.8% of cases. B(ІІІ) and AB(ІB) groups were less often associated with the erosive form of OLP and were observed in 17.3±0.1% and 2.0±0.1% of cases, respectively. The integration of A(ІІ) group in the erosive form of OLP was 30.5±0.1%, but the indicator was higher than in individuals with B(III) and AB(IV) groups. Hyperkeratotic form of OLP was more often observed in A(II) carriers than in 0(I) and was 44.1±0.1% versus 28.7±1.8%, respectively. With blood group B (ІІІ), the relationship with OLP is not traced. Correlative relationship with erythrocyte blood antigens of the ABO system in patients with oral lichen planus was established. Risk groups for the development of erosive and hyperkeratotic forms of lichen planus in patients with gastrointestinal tract pathology O(I)&gt;A(II)&gt;B(III) – with erosive form and A(II)&gt;O(I)&gt;B(III)) – with hyperkeratosis.

ABO blood groups and increased risk for the development of vascular involvement in Behçet's disease.

Inflammatory endothelial activation is a prominent feature of vascular involvement in Behçet's disease (BD), which is usually accompanied by a thrombotic tendency. Recent studies suggest an association between ABO blood groups and thrombotic vascular disease in those carrying non-O (A, B, and AB) groups. This study aimed to analyse the contribution of ABO blood groups to the vascular involvement in BD. In this retrospective study, BD patients with available ABO blood group data and meeting the ISG criteria were included in the study. The presence of vascular involvement, its clinical characteristics, and the data about other manifestations were recorded from the patient charts. This study was conducted in 411 patients; 143 (34.8%) were carrying O and 268 (65.2%) were carrying non-O groups. The vascular involvement was significantly more frequent and the risk for overall vascular and venous events was up to 2-fold higher in the patients with non-O groups. After adjustments for age, sex, and comorbidities, the risk for arterial disease was also found to be increased in association with non-O groups. ABO blood groups were shown to be independent risk factors for vascular BD by multiple regression models based on known predisposing factors. Compared with other non-O blood groups, the patients carrying blood group B had a higher risk for vascular events. The results of this preliminary study show the potential contribution of ABO blood groups to the vascular-BD phenotype and suggest an increased risk for vascular BD in association with non-O blood groups.

Genotyping for Weak and Partial D Rh Status to Optimize Usage of Limited Blood Supplies

Abstract Introduction The Rh antigen group, expressed on erythrocytes and encoded by highly polymorphic RHD and RHCE genes on chromosome 1 (1p36-p34), is notable in transfusion medicine due to its high polymorphism, strong immunogenicity and ability to cause hemolytic transfusion reactions in patients and hemolytic disease of the fetus and newborn (HDFN). The D antigen specifically contains multiple epitopes with variations that include decreased expression (weak D) or loss of certain epitopes (partial D) which expose patients to risk of alloimmunization depending on the subtype of the Rh(D) antigen. Hence, serologic weak D testing followed by molecular testing is not performed except for donors testing negative for Rh(D) antigen and newborns typing negative for Rh(D) and born to Rh(D) negative mothers. Given the current shortages of blood supplies, understanding patients’ genotypes in the context of weak or partial D-typing and risk of alloimmunization can be essential in the management of increasingly limited supplies of red blood cell (RBC) units. Objective To further characterize patients that initially type negative for Rh(D) but positive for weak D with molecular testing to investigate risk of alloimmunization, retype the Rh(D) and avoid unnecessary use of Rh(D) negative RBC units during critical shortages of RBC units. Methods We collected the results of ABO/Rh(D) typing for patients with negative Rh(D) testing but positive weak D test over a period of four weeks in December 2023 and had D-variant molecular testing performed by a reference laboratory. Initial serologic ABO/Rh(D) was performed in tube followed by weak D testing by indirect Coombs test in tube. Results The total number of patients who initially tested negative for Rh(D) but positive (weak to +4) for weak-D was three patients. Two patients showed a probable genotype of RHD*01W.1 (RHD* weak type 1, 809T&amp;gt;G (V270G)) homozygous which indicated the presence of weak D+ type 1. Patients with weak D+ type 1 can receive Rh(D) positive red cell units, and they are not at risk of alloimmunization and developing anti-D. The third patient showed a probable genotype RHD*DVI type 2 homozygous (lack of Rh(D) exons 4 through 6) and indicated the presence of partial D antigen. Patients with partial D antigen should receive RH(D) negative red cell units as they are at risk of alloimmunization and developing anti-D. Conclusions Although the vast majority of Transfusion Medicine services do not perform the serologic weak D test with reflex to molecular testing, characterizing patients who test negative with initial serologic Rh(D) testing with serologic and molecular D-tests may aid in retyping the Rh(D) of patients during critical shortages, particularly for patients with ABO blood group O.

C1q Binding Ability for Prior Risk Assessment of Acute Antibody-Mediated Rejection in ABO-Incompatible Kidney Transplantation.

In ABO blood group incompatible kidney transplantation (ABO-I), potential issues on acute antibody-mediated rejection (ABMR) remain to be solved. This study aimed to assess the risk factors of acute ABMR using recipient- or donor-derived specimens. Quantitative analysis of A/B antigen expression was conducted in 104 donor kidney tissues (Kt), platelets (Plt), and red blood cells (RBC) by immunohistochemical staining or flow cytometry (FCM). ABO-I pre-transplant recipient serum samples (ABMR = 12, non-ABMR = 27) were extracted by propensity score matching. Anti-A antibody titers of IgM, IgG and IgG subclasses, and C1q binding ability (%) on antibody were measured using RBC-FCM. No association was observed between ABMR and A/B antigen expression levels in donor's Plt, RBC, or Kt. In recipient's sample, C1q-IgG binding ability was significantly higher in the ABMR group than in the non-ABMR group (C1q-IgG: 9.04% vs. 5.93% p = 0.049). Neither the A/B antigen expression level in donors (grafts) nor anti-blood group IgG/IgM antibodies in recipient sera before desensitization seemed to influence ABMR incidence in ABO-I. In contrast, C1q-IgG binding ability could be a potential predictor for ABMR in ABO-I.

A 6-month Review of pRBC Transfusion Practices in a Tertiary Institution in Brooklyn, NY

Abstract Introduction/Objective Many factors are considered when managing hospital blood inventory. Because demographics and types of services vary per institution, a conscious effort to survey the prevalence of different blood types is necessary to make better predictions of inventory adequacy and decrease inappropriate use of O pRBC units. Methods/Case Report We reviewed the transfused pRBC units between October 2023 and March 2024 to determine the number of patients receiving ABO-type specific units and the number of D+ patients receiving D- units. Results (if a Case Study enter NA) After review, the patient population was found to be approximately 80% African Americans. Most of our patients were D+ with a monthly average of 224 patients. In contrast, we served 15 D- patients per month (PPM). Between 21-33% of D+ patients received D- units. O blood type was the most common, with an average of 224 PPM, followed by A blood type at 57 PPM and B blood type at 51 PPM. Since we see an average of 10 AB blood type patients monthly, it wasn’t surprising that they all received non-type specific units. Noteworthy is the significant proportion of A and B blood type patients receiving ABO type-specific units, ranging from 74-85% for A blood type and 70-90% for B blood type. Conclusion Our institution’s commitment to hemovigilance and conservation of O units is evident in the relatively high percentage of patients receiving ABO-type specific units. It is worth noting that we are a tertiary institution mainly serving the African American population. This creates a unique need to maintain adequate O units for emergency transfusion and increase the possibility of using O units to meet our sickle cell disease patients’ needs. Given that our demographics are primarily D+, some of our D- units were utilized in D+ patients. By adhering to our transfusion protocol and surveying our patients’ ABO and D blood types, we can anticipate our inventory needs and help prevent future O pRBC shortages.

Is ABO blood type a risk factor for adjacent segment degeneration after lumbar spine fusion?

This study aimed to explore associations between ABO blood type and postoperative adjacent segment degeneration/disease (ASD) following lumbar spine fusion, as well as evaluate differences in spinopelvic alignment, perioperative care, postoperative complications, and patient-reported outcome measures (PROMs). An ambispective study was performed. Patients who underwent posterolateral or posterior lumbar interbody fusion were included. Demographic, perioperative and postoperative, clinical, and blood type information was recorded. Pre- and post-operative radiographic imaging was analyzed for alignment parameters and development of ASD. 445 patients were included, representing O+ (36.0%), O- (5.2%), A+ (36.2%), A- (6.3%), B+ (12.1%), B- (1.6%), and AB+ (2.7%) blood types. Most patients were female (59.1%), and had a mean age of 60.3 years and BMI of 31.1kg/m2. Postoperatively, groups did not differ in duration of the hospital (p = 0.732) or intensive care unit (p = 0.830) stay, discharge disposition (p = 0.504), reoperation rate (p = 0.192), or in-hospital complication rate (p = 0.377). Postoperative epidural hematoma was most common amongst A + patients (p = 0.024). Over a mean of 11.0 months of follow-up, all patients exhibited similar improvement in PROMs, with 132 (29.7%) patients developing radiographic evidence of ASD. B + patients were significantly more likely than A + and O + patients to develop spondylolisthesis and ASD (p < 0.05). No significant differences in sagittal alignment parameters and number of levels of fusion were found (p > 0.05). This is the first large-scale study to address and demonstrate proof-of-principle that ABO blood type, a non-modifiable risk factor, is associated with ASD following lumbar spine fusion.

COVID-19 Is a Coronary Artery Disease Risk Equivalent and Exhibits a Genetic Interaction With ABO Blood Type.

COVID-19 is associated with acute risk of major adverse cardiac events (MACE), including myocardial infarction, stroke, and mortality (all-cause). However, the duration and underlying determinants of heightened risk of cardiovascular disease and MACE post-COVID-19 are not known. Data from the UK Biobank was used to identify COVID-19 cases (n=10 005) who were positive for polymerase chain reaction (PCR+)-based tests for SARS-CoV-2 infection (n=8062) or received hospital-based International Classification of Diseases version-10 (ICD-10) codes for COVID-19 (n=1943) between February 1, 2020 and December 31, 2020. Population controls (n=217 730) and propensity score-matched controls (n=38 860) were also drawn from the UK Biobank during the same period. Proportional hazard models were used to evaluate COVID-19 for association with long-term (>1000 days) risk of MACE and as a coronary artery disease risk equivalent. Additional analyses examined whether COVID-19 interacted with genetic determinants to affect the risk of MACE and its components. The risk of MACE was elevated in COVID-19 cases at all levels of severity (HR, 2.09 [95% CI, 1.94-2.25]; P<0.0005) and to a greater extent in cases hospitalized for COVID-19 (HR, 3.85 [95% CI, 3.51-4.24]; P<0.0005). Hospitalization for COVID-19 represented a coronary artery disease risk equivalent since incident MACE risk among cases without history of cardiovascular disease was even higher than that observed in patients with cardiovascular disease without COVID-19 (HR, 1.21 [95% CI, 1.08-1.37]; P<0.005). A significant genetic interaction was observed between the ABO locus and hospitalization for COVID-19 (Pinteraction=0.01), with risk of thrombotic events being increased in subjects with non-O blood types (HR, 1.65 [95% CI, 1.29-2.09]; P=4.8×10-5) to a greater extent than subjects with blood type O (HR, 0.96 [95% CI, 0.66-1.39]; P=0.82). Hospitalization for COVID-19 represents a coronary artery disease risk equivalent, with post-acute myocardial infarction and stroke risk particularly heightened in non-O blood types. These results may have important clinical implications and represent, to our knowledge, one of the first examples of a gene-pathogen exposure interaction for thrombotic events.