[The rare blood groups: a public health challenge].
A rare blood group is usually defined as the absence of a high prevalence antigen or the absence of several antigens within a single blood group system, if its prevalence in France is 4/1000 or less in the general population. An individual with a rare blood phenotype can develop a naturally-occurring or immune antibody corresponding to his rare specificity. In case an extremely low stock of compatible blood is available at the national level, a so-called "transfusion deadlock" is described. Most of the individuals with a rare blood group are coincidently identified when a routine pretransfusion testing or pregnancy follow-up is performed, if the antibody(ies) corresponding to the rare specificity is(are) present. Other individuals are discovered following a systematic red cell typing, or family investigations in siblings. One hundred and twenty-one rare blood specificities and 42 rare blood genotypes are currently defined at the French National Reference Laboratory for Blood Groups (CNRGS-Paris). The French national registry of individuals with a rare blood phenotype/genotype includes about 9600 people, who are urged to regularly donate blood for the National Rare Blood Bank. This bank, based on a homologous blood transfusion program, is in charge of the long-term storage of rare frozen blood units, that can only be delivered after receiving authorization from the CNRGS. The global and individual care management of the individuals with a rare blood group, concerning potentially several hundred thousand people in France, requires a close cooperation between all the protagonists within the transfusion chain.
Peyrard
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Inserm, U665, centre national de référence pour les groupes sanguins, institut national de la transfusion sanguine, 20, rue Bouvier, BP 79, 75522 Paris cedex 11, France. tpeyrard@ints.fr
Pham
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Le Pennec
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Rouger
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D001771:Blood Banks / Q000191:economics / Q000458:organization & administration; D001782:Blood Donors; D001789:Blood Group Antigens / Q000032:analysis / Q000235:genetics; D001788:Blood Grouping and Crossmatching; D001793:Blood Preservation; D003362:Cost-Benefit Analysis; D015925:Cryopreservation; D005260:Female; D005602:France; D005787:Gene Frequency; D005838:Genotype; D006801:Humans; D008297:Male; D011247:Pregnancy; D011634:Public Health; D012042:Registries; D012959:Socioeconomic Factors; D065227:Transfusion Reaction
D001789:Blood Group Antigens