title: Molecular blood typing augments serologic testing and allows for enhanced matching of red blood cells for transfusion in patients with sickle cell disease.
abstract: BACKGROUND
  Sickle cell disease (SCD) patients have dissimilar red blood cell (RBC) phenotypes compared to the primarily Caucasian blood donor base due, in part, to underlying complex Rh and silenced Duffy expression. Gene array-based technology offers high-throughput antigen typing of blood donors and can identify patients with altered genotypes. The purpose of the study was to ascertain if RBC components drawn from predominantly Caucasian donors could provide highly antigen-matched products for molecularly typed SCD patients.
  
  
  METHODS
  SCD patients were genotyped by a molecular array (HEA Beadchip, BioArray Solutions). The extended antigen phenotype (C, c, E, e, K, k, Jk(a) , Jk(b) , Fy(a) , Fy(b) , S, s) was used to query the inventory using different matching algorithms; the resulting number of products was recorded.
  
  
  RESULTS
  A mean of 96.2 RBC products was available for each patient at basic-level, 34 at mid-level, and 16.3 at high-level stringency. The number of negative antigens correlated negatively with the number of available products. The Duffy silencing mutation in the promoter region (67T>C) (GATA) was found in 96.5% of patients. Allowing Fy(b+) products for patients with GATA increased the number of available products by up to 180%, although it does not ensure prevention of Duffy antibodies in all patients.
  
  
  CONCLUSIONS
  This feasibility study provides evidence that centers with primarily Caucasian donors may be able to provide highly antigen-matched products. Knowledge of the GATA status expands the inventory of antigen-matched products. Further work is needed to determine the most clinically appropriate match level for SCD patients.
authors.affiliation: Puget Sound Institute of Pathology and Puget Sound Blood Center, Seattle, Washington 98104, USA.
authors.forename: Katie
authors.initials: K
authors.lastname: Wilkinson
authors.forename: Samantha
authors.initials: S
authors.lastname: Harris
authors.forename: Prashant
authors.initials: P
authors.lastname: Gaur
authors.forename: Askale
authors.initials: A
authors.lastname: Haile
authors.forename: Rosalind
authors.initials: R
authors.lastname: Armour
authors.forename: Gayle
authors.initials: G
authors.lastname: Teramura
authors.forename: Meghan
authors.initials: M
authors.lastname: Delaney
mesh_terms: D000328:Adult; D000465:Algorithms; D000755:Anemia, Sickle Cell / Q000097:blood / Q000453:epidemiology / Q000276:immunology / Q000628:therapy*; D001782:Blood Donors; D001787:Blood Group Incompatibility / Q000453:epidemiology / Q000517:prevention & control; D001788:Blood Grouping and Crossmatching / Q000379:methods*; D017707:Erythrocyte Transfusion; D006801:Humans; D046228:Microarray Analysis / Q000379:methods; D008875:Middle Aged; D058889:Molecular Typing / Q000379:methods*; D015995:Prevalence; D012698:Serologic Tests / Q000706:statistics & numerical data; D015854:Up-Regulation; D055815:Young Adult