title: Molecular matching of red blood cells is superior to serological matching in sickle cell disease patients.
abstract: OBJECTIVE
  To evaluate the usefulness of DNA methods to provide a means to precisely genotypically match donor blood units for the antigen-negative type of 35 sickle cell disease patients.
  
  
  METHODS
  Red blood cell units were investigated for ABO, D, C, c, E, e, K, Fy(a), Fy(b), Jk(a), Jk(b), S, s, Di(a) and RH variants by performing a molecular array (Human Erythrocyte Antigen BeadChip(TM), BioArray Solutions), polymerase chain reaction followed by restriction fragment length polymorphism analysis and sequencing of patient samples and donor units that had been serologically matched based on the ABO, Rh and K phenotypes and the presence of antibodies.
  
  
  RESULTS
  Matches for 21 of 35 sickle cell disease patients presented discrepancies or mismatches for multiple antigens between the genotype profile and the antigen profile of their serologically-matched blood units. The main discrepancies or mismatches occurred in the RH, FY, JK and MNS systems. Eight Rh alloimmunized patients presented RHD and RHCE variants that had not been serologically identified. According to these results better matches were found for the patients with genotyped units and the patients benefited as shown by better in vivo red blood cell survival.
  
  
  CONCLUSIONS
  Molecular matching is superior to serological matching in sickle cell disease patients, decreasing the risk of transfusion reactions, especially delayed transfusion reactions to existing alloantibodies and preventing alloimmunization.
authors.affiliation: Universidade Estadual de Campinas - UNICAMP, Campinas, SP, Brazil.
authors.forename: Daiane Cobianchi
authors.initials: DC
authors.lastname: da Costa
authors.forename: Jordão
authors.initials: J
authors.lastname: Pellegrino
authors.forename: Gláucia Andréia Soares
authors.initials: GA
authors.lastname: Guelsin
authors.forename: Karina Antero Rosa
authors.initials: KA
authors.lastname: Ribeiro
authors.forename: Simone Cristina Olenscki
authors.initials: SC
authors.lastname: Gilli
authors.forename: Lilian
authors.initials: L
authors.lastname: Castilho
keywords: Anemia, sickle cell; Blood group antigens; Isoantibodies/blood; Molecular typing