Blood Grouping Research Articles

Interference of anti-M antibody with ABO blood grouping — own experience

Interference of anti-M antibody with ABO blood grouping — own experience

A Study of A1 and A2 Subtypes Among Whole-Blood Donors With Blood Groups A and AB at the Blood Center of a Tertiary Care Institute in Chhattisgarh.

The ABO blood group shows various subtypes due to the heterogeneity of A and B alleles. The frequency of these subtypes varies in different populations. Studies related to the frequency of subtypes of blood groups A and AB are lacking in this region. So, we planned this study to estimate the prevalence of A1and A2 subtypes among the healthy blood donor population. This was a prospective study performed in the blood center of a teaching hospital in the Chhattisgarh state. Healthy whole-blood donors were included in the study after written informed consent. The conventional test tube method was used for performing forward and reverse blood grouping. Testing with anti-A1 and anti-H lectin was performed in blood groups A and AB. Additional tests such as saliva testing for secretor status and adsorption-elution were performed if needed. Four thousand one hundred twelve donor samples were studied, out of which 1170 showed A antigen. Among 1170 samples, 74.6% were blood group A, and 25.4% were AB. Among blood group A, 92.3% were A1and 3.3% A2,and the rest were other subtypes, while in AB, it was 85.2% A1B and 14.8% A2B. Two cases of anti-A1 antibodies were also noted, which were clinically insignificant. We observed a significantly higher proportion of A2B than A2 in our study population. We also found a large proportion of Aint in the study participants. Testing with anti-A1 andanti-H lectin is recommended in blood groups A and AB to determine various subtypes and prevent any incompatibility.

Role of direct antiglobulin test in anemia under evaluation: Its prevalence, laboratory workup, and significance in further patient management-A study from eastern India.

The direct antiglobulin test (DAT) is an important diagnostic tool for immune hemolytic anemia (IHA). The present study was primarily aimed to identify the prevalence of DAT positivity in anemia patients along with its specificity . A three months follow up of the DAT positive patients were performed for the response during course of illness in terms of transfusion requirement, hemoglobin level, persistence of DAT. This cross sectional study was performed at a government medical college on symptomatic anemia patients. At initial evaluation, complete blood count (CBC), blood grouping and DAT were performed in the EDTA blood. DAT positive blood samples were analyzed for their immunoglobulin specificity, auto or alloantibody type. Acid elution and red cell phenotyping were performed wherever applicable.Their clinical presentation, hematological and biochemical parameters of hemolysis were evaluated. Statistical analysis was performed on the results on SPSS (Version 23.0;.USA) and Graph pad Prism version 9. P value <0.05 was considered significant. DAT was present in 64 out of 501 patients with male female ratio 1: 4. Warm AIHA (WAIHA) was 93.7% with secondary WAIHA 60%. IgG was associated in 86% DAT positive samples, Only C3d was 14%. All the 4 cold AIHA (6.3%) had a higher antibody titre and thermal amplitude. DAT strength was directly proportional to the degree of hemolysis. During 3 months follow up , persistence of DAT and blood transfusion requirement was more in secondary WAIHA . Hemoglobin increment was more in primary WAIHA (75%). DAT played a significant role in the diagnosis as well as evaluation of AIHA.

Analysis of human ABO Blood Group as a risk factor with knee osteoarthritis at tertiary care hospital in Pakistan.

To investigate the association and risk estimation of ABO blood group distribution and clinical attributes in patients with Knee Osteoarthritis. This was a hospital-based study conducted at, Liaquat University Hospital Hyderabad from December, 2019 to December, 2022 to investigate this least researched area of highly prevalent musculoskeletal disease in Pakistan. Non-Probability Convenience Sampling was used for selecting 190 cases of confirm Knee Osteoarthritis patients diagnosed by Orthopedic surgeon based on standard clinical and radiographic criteria. Data were analyzed using IBM-SPSS version 23.0. Percentages and frequencies were counted for categorical data. Pearson Chi Square test and fisher's exact test were used to check the association and Multinomial Logistic Regression was used to estimate the risk for moderate and severe kellgren grading Knee Osteoarthritis (KOA) cases with ABO blood grouping in comparison of mild Kellgren grading. A total of 190 cases of Knee Osteoarthritis (KOA) were included in the study. Females (61.6%) and patients with age 50 and above were 40.5 % were found in greater proportion. Majority (41.6%) were classified radiologically as mild cases with O group (39.5%) and positive Rh antigen (95.8%). Strong association (p = <0.01) was found between gender, age group and ABO blood group with KOA radiological Kellgren and Lawrence score. There is strong relation in between radiological grading of knee osteoarthritis severity and A blood group, gender and age.

Gender Identification by Fingerprint Pattern and Salivary Blood Group Antigen Expression: A Forensic Approach.

Introduction Fingerprints found at the crime scene are important and valuable evidence, as they are unique to every individual. Determining the blood group from the blood samples obtained at the site of the crime helps in identifying a person. However, where blood stains are not available, saliva obtained at the crime site can be used to identify the victim. Since fingerprint patterns and blood groups are unique to every individual and remain unchanged throughout life, the correlation between dermatoglyphics and blood groups can be of use in victim identification. Objectives The present study is conducted with the objective of finding out if there is any association between the distribution of fingerprint patterns and blood groups and if this association is of use in gender identification. Materials and method Fingerprint patterns were determined in 200 (females: n = 152, males: n = 48) dental undergraduate students in the age range of 18 to 24 years. ABO blood grouping was done on saliva by using the absorption-elution method. To determine the accuracy of ABO blood group determination using saliva, it was correlated with the ABO blood grouping in blood. Observations and result The most common fingerprint pattern was found to be loops (87, 43.50%), followed by whorls (81, 40.50%) and arches (32, 16.00%). The most common blood group was B (68, 34%), followed by O (46, 23%) and A (42, 21%), and the least common was AB (12, 6%). A higher percentage of secretors in saliva was observed in females (130, 86%) than males (38, 79%). The correlation of gender with blood group and fingerprint pattern showed that in males, the most common blood group was B (20, 42%), and the most common fingerprint pattern was whorls (21, 44%). In females, the most common blood group was B (48, 32%), while the most common fingerprint pattern was loop (68, 45%). Conclusion Present study reports an association between blood group and dermatoglyphics, which may help in gender identification. Saliva can be used as a helpful tool in victim identification in cases where blood stains are not available.

Loss of Blood Group Antigens in Haematolymphoid Malignancy: A Case Series from a Cancer Institute from North East India

Introduction: Altered expression of blood group antigens has been reported to be associated with both solid as well as haematological malignancies. This usually results from genetic mutation leading to incomplete as well as abnormal synthesis of antigens. Transitional loss of RBC antigens especially from ABO system is most commonly found in haematological malignancies causing blood group discrepancies and followed by reversal to its historical blood group during remission. Loss of A, B antigens has also been associated to play a role in lung, bladder and colon cancers. However not much data is available regarding haematological malignancies.Methods and Methodology: Retrospective review of blood group discrepancy (Forward group) in patients admitted for haematolymphoid malignancy at our institute was done during a period of 3.5 years (13/3/2020 till 12/9/2023). Blood grouping done by Column agglutination test were repeated by conventional tube method. Further confirmation of the group was done by saliva test and adsorption elution test as indicated. The detail history of the patient was collected from the hospital records and analysed. Results: A total of 7 patients presented with either loss or decrease in antigen expression. Most common diagnosis was Acute Myeloid Leukaemia (AML) with FLT3 mutation and most common antigen affected was A. Conclusion: Haematolymphoid malignancies has been associated with loss of blood group antigens causing group discrepancy. Blood transfusion is an integral part of the supportive care in these patients. Hence, proper work up of blood group discrepancy cases should be done and recorded so as to prevent delay in blood transfusion.

Discrepancy in ABO Blood Grouping: A Report of B Subgroup with Cold Alloantibody

The ABO antigens are the most important in both blood transfusion and transplantation as their antibody can cause severe haemolytic transfusion reaction when ABO-incompatible transfusion occurs. It has been claimed that variants of the ABO blood group are very rare, including B subgroups. We reported a young healthy female with B subgroup and underlying cold-reacting alloantibody causing challenges in determining of her ABO blood group. Initial ABO blood grouping was misinterpreted as group O. Presence of alloantibody in her plasma was suspected after revealing positive antibody screening. Repeated blood grouping at 37oC revealed a discrepancy of the forward and reverse grouping, which suggested B subgroup. Cross-matching showed difficulties in finding compatible blood with both group O and B cells due to the presence of clinically significant cold alloantibody. Determining of correct ABO blood group is mandatory in transfusion practices as haemolytic transfusion reaction can be prevented.

Routine pretransfusion testing before primary total hip or knee arthroplasty are an expensive and wasteful routine. Systematic review and meta-analysis.

The excessive routine ordering of pretransfusion tests (blood typing, screening, and cross-matching) for surgical cases incurs significant unnecessary costs and places an undue burden on transfusion services. This study aims to systematically review the literature regarding the necessity of routine pretransfusion tests before total hip arthroplasty (THA) or total knee arthroplasty (TKA) and summarize their outcomes. A systematic review and meta-analysis were performed. The study's characteristics, the prevalence of over-ordering pretransfusion tests, transfusion rates, and potential cost savings to the healthcare system were analyzed. The study included 17,667 patients. Pooled results revealed a 96.3% over-ordering pretransfusion test rate (95% CI: 0.92-1.00; p < 0.001) among patients undergoing primary THA or TKA. The pooled prevalence of hospital transfusion rate was 3.6%. Notably, there were statistically significant differences in preoperative hemoglobin (Hb) levels between patients not requiring transfusion (Hb = 13.9g/dl; 95% CI 12.59-15.20; p < 0.001) and those needing transfusion (Hb = 11.9g/dl; 95% CI 10.69-13.01; p < 0.001) (p = 0.03). The per-patient total cost savings ranged from 28.63 to 191.27 dollars. Our study suggests that routine pre-transfusion testing for all patients undergoing primary THA or TKA may be unnecessary. We propose limiting pretransfusion test orders to patients with preoperative hemoglobin levels below 12g/dl in unilateral primary TKA or THA. This targeted approach can result in significant cost savings for healthcare systems and transfusion services by reducing the over-ordering of pretransfusion tests in these surgical procedures.

Relationship Between Blood Group and Obesity Reduction Through Diet Among Adults of Urban Bihar

ABO blood system is not only important for determining the lifestyle diseases, blood transfusion and exchange but it has also been found to be highly relevant to genetic marker of obesity. Recent studies are trying to explore the relation between blood grouping and obesity, and blood group diets and management of obesity. But still there are limited studies related to reduction of weight from blood group diets. The aim of this study is to examine the association of blood groups and weight reduction through a Moderate-Fat, Balanced Nutrient Reduction Diets among overweight and obese adults. A longitudinal study was conducted over 175 overweight and obese adults (&gt;18 years and &lt;60 years of age) of urban Bihar. A planned diet regime was followed by participants for a period of six months, and their anthropometric measurements were used for statistical analysis. There were substantial decreases in weight, BMI and waist circumference across different blood groups resulted through moderate-fat balanced nutrient reduction diet plan in both genders. For all blood groups, BMI reduction was at least 3.78 kg/m2 through the program, and the program was most effective for blood group O positive participants.

CEBPA double mutations associated with ABO antigen weakness in hematologic diseases

AbstractABO antigen weakness is rarely observed in ABO typing for transfusion. Hematologic diseases and associated gene mutations have been suggested as potential causes of this phenomenon, yet the precise etiology has not been elucidated. Through ABO typing and genetic analysis data conducted over 7 years, we have reconfirmed the association between ABO antigen weakness and hematologic diseases, especially acute myeloid leukemia (odds ratio [OR], 2.55; 95% confidence interval [CI], 1.12-5.83) and myelodysplastic syndrome (OR, 6.94; 95% CI, 2.86-16.83), and discovered previously unidentified candidate genes, CEBPA (OR, 43.70; 95% CI, 18.12-105.40), NRAS (OR, 3.37; 95% CI, 1.46-7.79), U2AF1 (OR, 8.12; 95% CI, 2.86-23.03), and PTPN11 (OR, 4.52; 95% CI, 1.51-13.50), seemingly associated with this phenomenon. Among these, CEBPA double mutations displayed a significant association, with ABO antigen weakness being observed in 20 of the 25 individuals (80.0%) possessing these mutations. From this study, new factors associated with ABO antigen weakness have been identified.

Detection of ABO Blood Groups From Dentin and Pulp by Using the Absorption-Elution Technique: A Forensic Cross-Sectional Study Among the Population of the Al Jouf Province, Saudi Arabia.

Background and objective Human teeth have a significant forensic importance. As they are the hardest of all human tissues, they are not just chemically stable but also their characteristics are maintained for a long time after death even in the most harsh environmental conditions. Despite the advances made in DNA analysis, fingerprinting, etc., ABO blood grouping still plays a significant role in the forensic practice in the field of personal identification, paternity disputes, and several other scenarios including the identification of mass disaster victims. The term blood groups refers to inherited antigens on the surface of red blood cells (RBCs) detected by specific antibodies. Since tooth pulp contains numerous blood vessels, blood group antigens are most certainly bound to be present in tooth pulp. Various studies have shown that blood group antigens in the pulp and dentin are preserved as long as up to two years after the demise of an individual. Absorption-elution technique has been proven to be the most sensitive, reliable, and consistent method to determine the ABO blood group from both the pulp and dentine.This study aimed toascertain the ABO blood group from both the hard (dentin) as well as the soft tissue (pulp) of the tooth by using the absorption-elution (AE) technique and also to determine if there are any variations in identifying the blood groups from the teeth based on age and gender. Material and methods After obtaining due consent, we included patients of both genders aged between 16-60 years visiting the outpatient department (OPD) clinics at the College of Dentistry for periodontal or orthodontic extractions.One patient's blood type was determined by using the slide agglutination technique before any capillary blood extraction was performed; this patient served as a control. For this investigation, we used the pulp and powdered dentin samples taken from the dental extractions to test for the presence of ABO and Rhesus (Rh) factor antigens by using the AE method. The study samples were compared with the control for blood group determination. Statistical analysis was carried out using the chi-square test with Monte Carlo (MC) simulation to check for any correlation of blood grouping with age and gender. Results The dentin and pulp were shown to have positive blood group antigens for the ABO and Rh factors.While neither pulp nor dentin performed significantly differently in identifying the blood group antigens, pulp showed marginally higher accuracy.There was no discernibledifference regarding gender or age in the dentin or pulp of any of the 45 samples studied. Conclusions For determining an individual's blood type and Rh factor, both the hard (dentin) and soft (pulp) tissues of a tooth are valid sources. This is particularly helpful in forensic medicine cases where teeth are the onlyremains that can be viably used to find out a person's identity.

Systematic review of hematopoietic stem cell gene therapy approach in thalassemia: Comparative analysis in animal models.

Hematopoietic stem cell (HSC) gene therapy has shown potential as a therapeutic approach for thalassemia in recent years. However, a comparison of the varying gene therapy methods of HSC gene therapy in thalassemia has never been reviewed. This study aims to evaluate the utilization of HSC gene therapy approaches in animal models of thalassemia. A systematic review was conducted in five databases: PubMed, EBSCOHost, Science Direct, SCOPUS, and Proquest using a combination of the terms hematopoietic stem cell or hematopoietic stem cell or HSC, thalassemia, genetic therapy or gene therapy and animal model. Only journals published in English between 2008 and 2023 were included. This literature included six studies analyzing the use of HSC gene therapy in thalassemic mice models. The three outcomes being assessed in this review were globin levels, hematological parameters, and red blood cell (RBC) phenotypes. Gene therapy approaches for thalassemia using HSC showed significant improvement in β-globin levels and RBC phenotypes. Phenotypic improvements were also observed. These outcomes indicate good efficacy in gene therapy for thalassemia in mice models. Furthermore, more studies assessing the efficacy of HSC gene therapy in the human model should be done in future studies.

Red blood cell phenotype conundrum in twins: In vitro fertilization sequel

Red blood cell phenotype conundrum in twins: In vitro fertilization sequel

Ensuring Blood Grouping, Cross Matching, and Appropriate Storage and Delivery in Compliance with Quality Standards during Preparation and Delivery of the EQC Materials to the Participating Laboratories in Nairobi City County, Kenya

Ensuring Blood Grouping, Cross Matching, and Appropriate Storage and Delivery in Compliance with Quality Standards during Preparation and Delivery of the EQC Materials to the Participating Laboratories in Nairobi City County, Kenya

Correlation of ABO Blood Group Susceptibility to Disease Severity of SARS-COV-2: An Original Research

ABSTRACT COVID-19, the Ecumenical Pandemic that hit Wuhan, Hubei Province, China, in 2019 has instigated an emergency situation all over the globe. Current scientific corroborations highlighted the role of zoonotic cross-over species transmission for the spread of the deadly virus SARSCoV2. The proposition of ABO blood grouping to susceptibility for various infectious diseases has been documented in the past since blood group antigens constitute polymorphic traits that are inherited among humans, therefore are frequent targets in epidemiological studies. Aim: To correlate the ABO blood group susceptibility to disease severity in COVID-19-positive cases among Indian populations. Objectives: Association of ABO blood group patterns to disease severity in COVID-19-positive cases. Materials and Methods: A cross-sectional, observational study design was conducted among 700 confirmed COVID-19-positive cases admitted to the tertiary health care center in Maharashtra, India. The data collected were subjected to statistical analysis. Results: Blood group ‘A’ positive was frequent (40%) in severe COVID-19 (E group) disease, and ‘O’ positive blood group was frequent in moderate COVID-19 disease (34.62%). Conclusion: ABO Blood grouping can be used as one of the efficient biomarker for COVID-19, thereby providing a new platform for therapeutic applications in the field of research.

A Rare B-Subgroup Causing ABO Discrepancy in Blood Grouping: A Case Report

This is a 24-year-old gentleman with underlying status epilepticus, admitted for septic shock secondary to meningoencephalitis. On pretransfusion investigation, his blood grouping showed ABO discrepancy. His forward grouping showed negative reaction with anti-A, and anti-B while his reverse grouping showed strong 3+ reaction with A1 cell and no reaction with B cell. Repeated tests with new samples also showed similar results. Subsequently, test was repeated at room temperature and 4◦C with prolonged incubation and with enzyme treated cells. Forward grouping showed the same result while the reverse grouping showed enhancement with A1 cell (4+). We suspected B subgroup and proceeded with anti-H lectin test which showed 4+ reaction. Adsorption and elution study confirmed the presence of antigen B on patient’s RBCs. Therefore, it is necessary to resolve all discrepancies to ensure safe transfusion practice.International Journal of Human and Health Sciences Vol. 08 No. 01 Jan’24 Page: 99-102

Frequency of Rh and Kell antigens among blood donors: A retrospective analysis from a tertiary care center in Eastern India

Objectives: The phenotyping of Rh and Kell antigens plays a major role in preventing alloimmunization and adverse events in multi-transfused patients. This study tries to highlight the frequency of Rh and Kell antigens among the blood donors who donated blood at a tertiary care center located in Eastern India. Material and Methods: The study was conducted in the Department of Transfusion Medicine and Blood Bank of All India Institute of Medical Sciences, Patna, from January 2021 to March 2023 on 10,032 whole blood donors of blood groups A, B, O, and AB by column agglutination technique using gel cards for blood grouping and phenotyping. Results: A total of 10,032 whole blood donors of groups A, B, O, and AB were included in the study. The frequency of “D” antigen was 95.77% (n = 9,608), “C” was 90.47% (n = 9,076), “c” was 50.47% (n = 5,063), “E” was 15.9% (n = 1,595), “e” was 99% (n = 9,932), and “K” was 2.67% (n = 268). “c” antigen frequency was 45.81–49.48% in RhD positive blood groups and 100% in all the RhD negative blood groups while “C” antigen frequency was 92.04–94.68% in RhD positive blood groups, and 4–24.13% in RhD negative blood groups. Conclusion: Since pre-transfusion phenotyping in multi-transfusion patients is not routinely practiced, transfusion of at least Rh and Kell phenotyped donor red cells can lead to a great decrease in the risk of alloimmunization and adverse events related to transfusion.

Evaluation, Exploration and Management Strategies of a First Reported Rarest Case of Para-Bombay Blood Phenotype with E-Beta Thalassaemia from Bangladesh

Human H/h genetic polymorphism in ABO blood group system is rare and evidenced with Bombay and Para-Bombay blood group. This patient a 27-year-old-young man having ‘E-Beta thalassaemia’ incidentally has been identified as a case of ‘Para-Bombay phenotype’ after exploring with proper blood grouping, antibody detection and saliva inhibition study. Previously he was diagnosed as ‘O’ RhD positive and had two events of transfusion reaction during ‘O’ positive blood transfusion. In literature search and browsing there is dearth information on Para-Bombay Phenotype with E-Beta Thalassaemia. So far to our knowledge, this is the first reported case from Bangladesh of patient having ‘E-Beta Thalassaemia’ evidenced with rare ‘Para-Bombay blood Phenotype’. This study explores the laboratory work-out on Para-Bombay Phenotype and evaluates treatment strategies on this phenotype with concomitant E-Beta Thalassaemia. J Bangladesh Coll Phys Surg 2024; 42: 97-104

Fully genotyping and screening of clinically important blood-group antigens by MALDI TOF mass spectrometry.

Several molecular biology methods are available for high-throughput blood typing. In this study, we aimed to build a high-throughput blood-group genetic screening system for high-frequency blood-group antigen-negative rare-blood groups in donors and patients. The amplification primers for all blood-type gene fragments involving the selected alleles were designed for detection. Single-base extend primers were also designed based on specific loci. DNA fragments were detected by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MS) for the last nucleotide identification of amplification products in the extend step. The accuracy was verified by known samples. Thirty-six random samples were detected by serological tests and sequencing to verify the system stability. After verification, according to the collected known rare-blood-type samples, all the alleles designed to be detected matched with the validated single-nucleotide polymorphisms. The verification tests showed that all genotyping results of the random samples were in accordance with the findings of serotyping and sequencing. Then, 1258 random donor samples were screened by the built typing system after the verification. Three Fy(a-) and four s- were screened out in 1258 random blood samples. The multiple polymerase chain reaction-based MS detection system can be used in rare-blood-type screening with good accuracy and stability.

Cold Agglutinin Disease Unfurled in Laboratory and Blood Bank: A Little Poignant Observation Can Speak a Lot!

Autoimmune hemolytic anemias (AIHAs) are hemolytic anemias characterized by the production of autoantibodies against surface antigens on red blood cells. Cold agglutinin disease (CAD) is a relatively rare subcategory of AIHA, affecting mainly the middle-aged with anemia often being the presenting symptom. We present a case of a middle-aged female who was admitted for severe anemia under evaluation. A discrepancy in blood grouping was noted when request for blood transfusion was received in a blood bank, owing to autoantibodies interfering in testing. Routine complete blood counts showed temperature-based variations. A detailed workup confirmed a diagnosis of CA type of AIHA. The case reiterates the importance of good interdepartmental coordination between clinicians, laboratory, and blood bank, which helped clinch the diagnosis of CAD through the correlation of clinical findings, blood counts, and immunological and biochemical parameters.