Blood Group Testing Research Articles

Novel applications of nonwood cellulose for blood typing assays.

Paper-based microfluidics devices can create a new healthcare model. Cellulose is carbohydrate polymer biocompatible and hydrophilic. These characteristics enhance the development of user-friendly diagnostic devices, but the link between paper manufacturing process and performance of the devices is still unclear. Previous studies focused on either commercial papers or lab papers from wood-cellulose fibers, with different basis-weight. This work introduces the effect of refining process and lab paper from nonwood-cellulose fibers, focusing on sisal fibers to overcome the aforementioned challenge. Structural characteristics of paper, such as basis-weight and degree of refining, are optimized and correlated with blood typing test resolution. Unrefined sisal paper of 50 g/m2 and 100 g/m2 basis-weight exhibit a higher gray intensity level than refined paper, and also maximal capillary rise and a pore size suitable for blood grouping tests. Two different blood types were evaluated with results consistent with the traditional methods, testifying the usefulness of this methodology. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1533-1541, 2019.

Frequency and Distribution of ABO and Rhesus Blood Groups in Women of a Degree College

Background ABO and Rh Blood grouping systems are the most commonly used blood grouping systems in transfusion medicine despite the long list of several other blood groups discovered so far. They are genetically inherited and play a vital role in blood transfusions population genetic studies paternity testing anthropology and addressing medico legal issues.Aim To determine the distribution and frequency of ABO and Rhesus Rh blood groups in women studying in a Degree College.Material and Methods This study is a cross-sectional observational study which was conducted in a womenrsquos Degree College in Harihara. Students who consented for blood group testing were included in the study. Grouping was done by slide agglutination method using capillary blood obtained by finger prick. Standard antisera A B and D were used. Age of the individuals and their blood groups were noted down for analysis. Results were expressed in numbers and percentage.Results 351 students participated in the study. lsquoBrsquo and lsquoOrsquo formed the most common blood groups accounting for 34.2 and 33.7 respectively. Blood group lsquoArsquo accounted for 21.9 whereas lsquoABrsquo was the least common with 10.3. 96.9 students were Rhesus positive whereas only 3.1 were Rhesus negative.Conclusion Most frequently occurring blood groups were lsquoBrsquo and lsquoOrsquo whereas lsquoABrsquo was the least common blood group in the ABO system. Rhesus Rh positive blood group was significantly higher than the Rhesus Rh negative blood group.

Unusual Rhesus Antibodies as a Cause for Fetal Isoimmunisation

AbstractHemolytic disease of the newborn due to Rh isoimmunisation in a Rhesus D (Rh-D) negative mother with an Rh-D positive fetus is a well recognised entity. Although antibody to Rh-D antigen (anti-D antibody) was once the major cause of hemolytic disease of the fetus and newborn (HDFN), widespread adoption of antenatal and postnatal prophylactic anti-D immunoglobulin administration has resulted in a marked decrease in the prevalence of allo-immunisation due to the Rh-D antigen during pregnancy. However, at the same time, the maternal allo-immunisation to other red cell Rhesus antigens became more evident as a cause for HDFN, since no prophylactic immunoglobulins are available to prevent the formation of these antibodies. The authors report a case of a pregnant woman with AB negative blood group and positive indirect Coombs test (ICT) with rising middle cerebral artery peak systolic velocity (MCA-PSV) on follow up visits. Fetus required intrauterine transfusion. Fetal cord blood sampling revealed the fetus to be B negative and the direct Coombs test (DCT) was positive. On further testing, maternal serum was found to be positive for anti-D, anti-C and anti-G antibodies. Postnatally, the baby required double volume exchange transfusion. The authors highlight the importance of irregular antibody screening for women with obstetric history suggestive of HDNF. This could help in diagnosis and successful treatment of the affected fetus.

Serological and molecular biological analysis of ABO blood subgroup samples

Objective To explore the serological and molecular biological mechanisms of 2 cases of ABO blood subgroup samples. Methods A total of 2 unconfirmed blood samples which were investigated at the Institute of Blood Transfusion of Qingdao Blood Center for ABO blood group identification, on 21 October 2015 and 12 November 2015, were included in this study as study objects, respectively. Phenotypes of blood samples were detected with forward and reverse blood grouping testing, absorption and irradiation test. PCR-sequence specific primer (SSP) and direct sequencing methods were carried out to identify the genotypes of the samples. The haplotypes of exon 6, 7 and intron 6 were also analyzed by haplotype sequencing method. Results ① The serological identification of sample 1 was identified as Ael type. Direct sequencing showed that there was c. 940A>G heterozygous mutation in exon 7 of ABO gene. The results of haplotype sequencing showed that ABO genotype of this sample was Ax13/O02. ② The serological identification of the other sample was identified as Bel type. The results of the direct sequencing showed that there was c. 784G>A heterozygous mutation in exon 7 of the ABO gene. The haplotype sequencing results showed that the ABO genotype of this sample was Bw17/O01. Conclusions The combination of serological typing and gene sequencing is a reliable method for typing ABO blood subgroups of unconformity blood type individuals. Key words: ABO blood-group system; Gene sequence; Blood group serology; ABO genotyping; ABO blood subgroup

Blood Transfusion Selection in Patients with Autoimmune Hemolytic Anemia Producing Class Antibodies

To analyze the reasons for the incompatibility of cross matching in lymphoma patients complicated by autoimmune hemolytic anemia (AIHA), and to provide compatible blood to patients for multiple blood transfusion. The test tube method was used for routine identification of ABO blood group, Rh typing and direct anti-globulin test; the patients antibody was identified by saline water method, micro column gel card; and the saline water method, Polybrene method and antiglobulin method were used for blood cross matching test of the patients. In the serum of the patient, positive autoantibodies were detected, in the elution, the Ce antibody was detected. After infusion of the corresponding antigen-negative blood, the patient's hemoglobin level was significantly improved. Only firstly accurately identifying antibodies existed in serum and elution, then selecting corresponding antigen negative blood, can ensure the safety and effectiveness of blood transfusion.

Direct measurement of IgM—Antigen interaction energy on individual red blood cells

Most blood grouping tests rely on the principle of red blood cells (RBCs) agglutination. Agglutination is triggered by the binding of specific blood grouping antibodies to the corresponding RBC surface antigen on multiple cells. The interaction energies between blood grouping antibodies and antigens have been poorly defined in immunohaematology. Here for the first time, we functionalized atomic force microscope (AFM) cantilevers with the IgM form of blood grouping antibodies to probe populations of individual RBCs of different groups under physiological conditions. The force-mapping mode of AFM allowed us to measure specific antibody – antigen interactions, and simultaneously localize and quantify antigen sites on the scanned cell surface. This study provides a new insight of the interactions between IgM antibodies and its corresponding antigen. The technique and information can be translated to develop better blood typing diagnostics and optimize target-specific drug delivery for medical applications.

Incompatible Crossmatch with Bombay Phenotype (Oh) - A Case Report

Blood serology plays a vital role in transfusion medicine. Presence of an irregular antibody (anti H) in the plasma reacting with all the red cells exhibiting the normal red cell ABO phenotype, the h/h (Bombay) phenotype. The h/h phenotype also known as Oh or Bombay blood group is a rare blood type. It was first discovered in Bombay (Mumbai) in India by Dr.Y.G. Bhende et al in 19521 Generally present in about 4 per million of the human population, though in some places such as Mumbai (Bombay) locals can have occurrences in as much as 1 in 10,000 of inhabitants2 It is also very rare in Bangladesh. The first case was reported in 1990 where three sisters in a same family were of 'Bombay' phenotype3. A 28-year-old male of Noakhali district was admitted to Apollo Hospitals Dhaka on 21st may 2016 with road traffic accident with pelvic fracture. His ABC and Rh blood group was detected as 0 positive by usual blood grouping test procedure. But his cross match was incompatible with several 0 positive blood units. Though the patient’s blood group phenotype initially mimic normal group 0 type by usual test procedure but became apparent when his serum was tested against group 0 red cells and strong Mediate spin agglutination developed at a thermal range 4° to 37°C. After testing with anti H Lectin, Ulex europaeus having anti H like activity, it was detected as Bombay blood group. Therefore, proper serum grouping using A cell, B cell and 0 cell is necessary to detect this group. Bombay phenotype individual do not express H, A and B antigen on their red cells and secretions but their plasma contains potent anti H, anti A and anti B due to lack H antigen4 Normal 0 group red cells does not have A or B antigen but their membrane expresses abundant H antigen. Anti H of Bombay phenotype serum gives incompatible cross match with all red blood cells of normal ABO phenotype containing H antigen. oh phenotype person can receive only autologous blood or blood from another Bombay blood group donor.5 This patient has received blood from her own sister who was also Bombay phenotype but his other four brothers were normal 0 group. Later on he was transfused with blood from Bombay blood group donor, arranged from “Think Foundation”, Mumbai, India for his orthopedic surgery. Both forward and reverse grouping is important for safe transfusion. If not followed, it may lead to people with Bombay blood group, not being detected and categorized as 0 group. Therefore, proper reverse grouping is necessary to detect this group and cross matching at different thermal range also plays a vital role in transfusion safety.Pulse Vol.9 January-December 2016 p.54-59

Quality of Antenatal Care Services in Demba Gofa Woreda, Gamo Gofa Zone, Rural Ethiopia

Background: Antenatal care is one of the evidence based interventions to decrease the probability of negative health outcomes for mothers and their newborns. This depends on the quality of care provided during each antenatal care visit. However little is known about factors contributing to quality of antenatal care service in public health center of Demba Gofa woreda. Objectives: To assess quality of antenatal care services in public health centers of Demba Gofa woreda. Methods: A facility-based cross sectional study design using quantitative and qualitative data conducted from March 25 to April 16‚ 2014. Using systematic random sampling method from 423 study subjects a sample of 418 pregnant women were sampled. The quantitative data was entered in to EpiData version 3.1 and was exported to SPSS version 20.0 for analysis. Bivariate and multiple variables analysis were carried out to identify factors associated with client satisfaction of antenatal care services. Variables with p value <0.05 were considered as statistically significant. Adjusted odds ratios were used to see the strength of association with 95% CI. Qualitative data was analyzed thematically by manually. The results were triangulated with quantitative data. Result: The proportion of mothers who were satisfied with antenatal care in this study was 21.5%. Women’s satisfaction with antenatal care was associated with frequency of ANC visit (AOR=1.9‚ 95% CI: (1.1, 3.3)), advise on nutrition (AOR=3.3‚ 95% CI: 1.3‚ 8.5), advise on birth preparedness (AOR=3.3‚ 95% CI: 1.1‚ 9.3)), closeness of the health center to mothers home (AOR=2.3‚ 95% CI 1.3‚ 3.9)). Provision of iron (AOR=0.14 (95% CI: 0.05‚ 0.3). Charge for service (AOR=3.4‚ (95% CI: 1.2‚ 9.5). Moreover 373 (89.2%) of the women received tetanus toxoid vaccine‚ 324 (77.5) mothers started antenatal care visit after first trimester. The recommended care component such as Venereal Disease Research Laboratory (VDRL) test, blood group and Rhesus factor tests were not done for most of the women. There was 67.18% over all skilled human resource gaps and none of the health professionals had taken training on focused antenatal care. Conclusion: The overall satisfaction of antenatal care services in this study was found to be low. First ANC visit‚ lack of advice on nutrition‚ lack of advice on birth preparedness‚ farness of the health center to mother’s home‚ provision of iron and Charge for service were independently associated with mothers satisfaction of antenatal care. As well lack of skilled health personal and not under taking recommended laboratory tests were revealed.

Application of a multiplex PCR genotyping assay of 31 red blood cell antigens for establishment of a panel of reference DNA in China

DNA based blood group genotyping has been widely used in clinical blood transfusions, and a number of different molecular blood group testing methods have been developed, including the detection of single nucleotide polymorphism (SNP) and genomic DNA sequencing. As the molecular bases of blood groups can differ widely between ethnic groups, a set of reference DNAs, especially for the Chinese population, is required for the development and validation of these methods, and for their optimal use in routine practice in China. In this study, a total of 100 DNA samples obtained from 60 established cell lines and 40 Chinese blood donors were typed for 31 red blood cell antigens of 13 blood group systems using a multiplex polymerase chain reaction (PCR) assay. Finally, nine DNA samples were selected to establish a panel of reference DNA that included M, N, S, s, Mur, Lu^a, Lu^b, Au^a, Au^b, K, k, Fy^a, Fy^b, Jk^a, Jk^b, Di^a, Di^b, Sc1, Sc2, Do^a, Do^b, Co^a, Co^b, Kn^a, Kn^b, In^b, Vel antigens and Fy (a-b-) null phenotype.

The Indonesian approach to reduce maternal mortality

BackgroundBlood transfusions are an important part of health care in Indonesia where the maternal mortality is 370. Haemorrhage (30·3%), hypertension (27·1%) and infection (7·3%) are the main causes of maternal mortality, with 78% of deaths occurring within 48 h after delivery. Unavailability of blood contributes to 9% of maternal deaths.AimsTo describe the national strategy for ensuring availability of safe blood as a means to reduce maternal mortality. The Ministry of Health Decree on collaboration between the Primary Health Centre (PHC) and Blood Centre (BC) on Blood Services was issued in 2015 to increase people's awareness in donating blood for every pregnant woman in the village. The PHC will do donor recruitment and selection, blood group and haemoglobin test, and physical check of the donor. Four eligible donors for every pregnant woman will be requested to donate blood at the BCs on 7–10 days before the childbirth time. The excess donated blood that is not used by intended pregnant woman will increase the availability of blood at the BC for other patients.ConclusionIndonesia has high maternal mortality that mostly due to haemorrhage. The unavailability of blood contributes to maternal mortality. Increasing people's awareness and willingness to donating blood voluntarily is expected to increase blood supply and improve management of postnatal haemorrhage.

Report on External Proficiency Testing for the ABO and D Blood Group Typing Tests in Blood Centers (2015)

Background: The Korean Blood Safety Commission has implemented external proficiency testing (PT) for blood grouping test (BGT) since 2011. We analyzed the results of 2015 PT for BGT including hemagglutination grade for ABO BGT to help in planning the future PT for BGT and improving the quality of blood centers (BC). Methods: Two kinds of whole blood survey samples composed of three panels for ABO grouping and three panels for D typing were sent to 68 institutes. Evaluation criteria for BGT were as follows: 'Good' for the answers matched with intended results, 'Acceptable' for the consensus answers other than that of 'Good', 'Unacceptable' for the answers other than those of 'Good+acceptable' as correct answers. Results: The answer rates of 'Unacceptable' for ABO BGT were 0% for A(A1) antigen (Ag), 1.5% for B Ag, and 1.5% for ABW (A2BW) Ag, 15% of blood centers were graded as 'Acceptable' for ABW (A2BW) Ag because they could not detect BW Ag. All answers for D typing were 'Good' except one institute reported wrong switched results as D positive and D negative. Hemagglutination grade for ABO BGT varied from 77.2%∼100% depending on blood groups and laboratories. Conclusion: Because some hospital BC could not detect BW Ag and there was a clerical error, continuous education should be required, and comparison of hemagglutination grade for ABO BGT of each BC would be helpful in improving quality of BC. (Korean J Blood Transfus 2016;27:68-78)

Guideline for blood grouping and red cell antibody testing in pregnancy.

Guideline for blood grouping and red cell antibody testing in pregnancy.

Seroprevalence of Hepatitis B Infection among First-Time Blood Donors in Faridpur, Bangladesh: A Cross-sectional Study

Background: Hepatitis B infection is a global threat for people of all age groups and is common in Bangladesh and other South Asian countries. Blood donors and blood donation can present important risk for hepatitis B infection. Our objective was to identify seroprevalence of hepatitis B virus among blood donors in Faridpur, Bangladesh. Methods: A cross-sectional study was conducted among 719 blood donors in the Faridpur district of Bangladesh from April to July 2013. Data was collected by non-probability convenient sampling maintaining inclusion and exclusion criteria. Face-to-face interview, blood grouping test, and hepatitis B surface antigen (HBsAg) screening were conducted. Results: About 30% of the blood donors were between 19 and 23 years of age, and 87.5% of them were males. Two-thirds (64.1%) of the donors were replacement donors, while the remaining 35.9% of them were voluntary donors. The overall seropositivity of HBsAg was found to be 1.5%. All infected blood donors were males. Hepatitis B infection was more prevalent in the 34–38 years age group and least prevalent among those older than 48 years of age. About 2% of replacement blood donors were infected with hepatitis B virus, compared to 0.7% among voluntary blood donors. Conclusion: Hepatitis B infection among blood donors is relatively lower than in other high-risk groups for hepatitis B infection in Bangladesh. Predominance of HBsAg among older adult groups, replacement donors, and the male gender can be a matter of public health concern.

Cell-free DNA fetal blood group testing for RhD-negative pregnant women: Implications for midwifery

Cell-free DNA (cfDNA) RhD testing of maternal plasma has been implemented in Avon as a clinical service, so that normal rhesus D-negative pregnant women (about 15% of pregnant women) are only given antenatal anti-D if the fetus is RhD positive. As a result, only RhD-negative women carrying a RhD-positive baby are given antenatal anti-D, meaning that about 40% of healthy RhD-negative pregnant women need not be exposed to a blood product that is pooled from many donors. This also means health services can conserve the use of a costly product (requiring deliberate sensitisation of volunteers) that can be in short supply, for those who need it. The cfDNA RhD test is now available in NHS laboratories and this article proposes that maternity services should implement this approach across the country.

Health profile of pregnant women attending urban health centre in Hyderabad, Telangana, India

Background: Maternal and child mortality is the outcome of multiple factors. Current maternal mortality in India is 254 per 100,000 live births. Improving the maternal and child health is an important public health goal of government of India. To prevent unwanted outcome of pregnancy, antenatal care (ANC) is most important method for early detection and prompt treatment of complications . Methods: A cross sectional study was conducted among pregnant women attending ANC clinic at urban health centre during September 2015 to November 2015. A pre tested semi-structured questionnaire was used for data collection. Data was collected from 102 pregnant women attained ANC clinic during study period. The data was compiled and analyzed using appropriate statistical tools. Results: In present study majority (46%) of pregnant ladies belong to 20-25 years of age group and 26% had consanguinous marriage. In our study gravida 3, gravida 4 and gravid 5 were 29%, 12% and 5% respectively. 52 % of pregnant ladies had 3 ANC visit, almost 62% of pregnant ladies had done haemoglobin examination and 57% blood grouping testing. Pregnancy outcome were live birth in 82.66 % and abortion in 16.69%. 41% were previous LSCS and 9% were home delivery. In this study we found that high risk pregnancy were 59.8% and main reason of being high risk were previous LSCS (52%), anaemia (40%). Conclusions: High quality antenatal care as well as knowledge and practice of community regarding maternal care during pregnancy are important to unwanted outcome of pregnancy.

Evaluation of Neonatal Hemolytic Jaundice: Clinical and Laboratory Parameters.

BACKGROUND:Neonatal jaundice that occurs in ABO or Rhesus issoimunisation has been recognized as one of the major risk factors for development of severe hyperbilirubinemia and bilirubin neurotoxicity.AIM:Aim of our study was to investigate clinical and laboratory parameters associated with hemolytic jaundice due to Rh and ABO incompatibility and compare results with the group of unspecific jaundice.MATERIAL AND METHODS:One hundred sixty seven (167) neonatal hyperbilirubinemia cases were included in the study, 24.6% of which presented with ABO/Rhesus type hemolytic jaundice, and the rest with unspecific jaundice. Evaluation included: blood count, reticulocites, serum bilirubin, aminotransferases, blood grouping, and Coombs test, also the day of bilirubin peak, duration of the hyperbilirubinemia, and additional bilirubin measurements.RESULTS:We showed significantly lower mean values of hemoglobin, erythrocytes and hematocrit and significantly higher values of reticulocytes in the group of ABO/Rh incompatibility compared to the group of jaundice of unspecific etiology; also an earlier presentation and a higher-grade jaundice in this group.CONCLUSIONS:The laboratory profile in ABO/Rh isoimmunisation cases depicts hemolytic mechanism of jaundice. These cases carry a significant risk for early and severe hyperbilirubinemia and are eligible for neurodevelopmental follow-up. Hematological parameters and blood grouping are simple diagnostic methods that assist the etiological diagnosis of neonatal hyperbilirubinemia.

Microfluidic PMMA-based microarray sensor chip with imaging analysis for ABO and RhD blood group typing.

Solid phase microarrays have been described for use in blood typing; red blood cells (RBCs) captured on immobilized antibodies were detected using surface plasmon resonance or fluorescence. We present antibody microarray on Poly (methylmethacrylate) (PMMA) surface coupled with microfluidic system for ABO and RhD blood typing. After immobilized by antigen-antibody interaction, the RBCs were detected by image recognition. The sensor surface was produced from grafted aminopropyltriethoxysilane (APTES) on photochemical modified PMMA surface by UV irradiation and subsequently reacted with glutaraldehyde cross-linking. The amine group of monoclonal antibody of anti-A, anti-B and anti-D was reacted with an aldehyde group on the glutaraldehyde modified surface, forming an imine linkage. RBCs were captured by the coated antibody via antigen-antibody interaction, and blood grouping was determined by microarray image cell counting. Suitable condition for RBC detection was 10% RBC concentration at 10μl/min flow rate. This setting eliminated non-specific RBC binding resulting in correct blood groups identification of all 136 samples tested. The platform showed good reproducibility with coefficient of variation of 2·17%, 3·62% and 2·51% for anti-A, anti-B and anti-D respectively. The antibody-coated surface can be stabilized by stabilizer coating and stored for long-term use. The PMMA array chip demonstrated its good accuracy and precision in rapid blood group testing. For its high throughput, the method has potential for use in large blood donation centre.

Malaria Parasitaemia among Blood Donors in Ilorin, Nigeria.

The prevalence of malaria parasitaemia among blood donors in Ilorin has not been documented. In this study, we determined the prevalence of malaria parasitaemia among blood donors in Ilorin, as well as, the sociodemographic and other factors associated with it. This was a hospital-based cross sectional study involving 308 consenting blood donors. The sociodemographic characteristics of participants as well as blood donation history were obtained using structured questionnaires specifically designed for this purpose. Giemsastained thick and thin blood films to identify malaria parasites were performed using standard method. ABO blood grouping and haemoglobin electrophoresis tests were also done using standard methods. The prevalence of malaria parasitaemia among blood donors in Ilorin was 27.3%. The parasite species found were more of Plasmodium falciparum(85.7%) than Plasmodium malariae(14.3%) . There was no age or sex difference in malaria parasitaemia. (p-value of 0.8 and 0.32 respectively). A greater proportion of blood group O individuals had malaria parasitaemia than groups A and B but this difference was not significant (p-value = 0.13). There was also no significant difference among haemoglobin genotypes. The prevalence of malaria parasites among blood donors in Ilorin is considerably high and lack of routine screening of blood puts recipients at risk. We recommend that routine screening for malaria parasites be commenced in our blood banks. Treatment of donor blood with riboflavin and UV light to inactivate malaria parasites and other infectious pathogens before they are transfused to patients may also be considered in our blood banks.

Blood groups and human groups: Collecting and calibrating genetic data after World War Two

Arthur Mourant's The Distribution of the Human Blood Groups (1954) was an “indispensable” reference book on the “anthropology of blood groups” containing a vast collection of human genetic data. It was based on the results of blood-grouping tests carried out on half-a-million people and drew together studies on diverse populations around the world: from rural communities, to religious exiles, to volunteer transfusion donors. This paper pieces together sequential stages in the production of a small fraction of the blood-group data in Mourant's book, to examine how he and his colleagues made genetic data from people. Using sources from several collecting projects, I follow how blood was encountered, how it was inscribed, and how it was turned into a laboratory resource. I trace Mourant's analytical and representational strategies to make blood groups both credibly ‘genetic’ and understood as relevant to human ancestry, race and history. In this story, ‘populations’ were not simply given, but were produced through public health, colonial and post-colonial institutions, and by the labour and expertise of subjects, assistants and mediators. Genetic data were not self-evidently ‘biological’, but were shaped by existing historical and geographical identities, by political relationships, and by notions of kinship and belonging.

Is Next Generation Sequencing the future of blood group testing?

Blood group genotyping has many advantages over conventional phenotyping for both blood donors and patients, and a number of high-throughput methods have now been developed. However, these are limited by a requirement for existing knowledge of the relevant blood group gene polymorphisms, and rare or novel mutations will not be detected. These mutations could be successfully identified by DNA sequencing of the blood group genes, and such an approach has been made feasible by the introduction of Next Generation Sequencing (NGS) technology. NGS enables many genes from multiple samples to be sequenced in parallel, resulting in sequencing information that could be used to obtain accurate blood group phenotype predictions in both blood donors and patients.