Analysis of various blood group genotypes and unexpected antibodies in Korean population for the establishment of the rare blood program

Abstract

It is often difficult to supply adequate amounts of blood for patients with rare phenotypes in Korea. Moreover, the definition of rare blood is ambiguous, and much remains to be clarified. In this study, the prevalences of various human erythrocyte antigens (HEA) were determined from the donor viewpoint, and the demands for specific antigen-negative blood were estimated from the patient viewpoint. The data will aid the establishment of a Rare Blood Program in Korea (KRBP). HEA genotyping of 419 blood donors (306 D-positives and 113 D-negatives) was performed using a Lifecodes RBC/RBC-R typing kit (Immucor, Norcross, GA, USA). A national recipient registry website has been established where each hospital-based blood bank voluntarily enters data on detected and identified antibodies, as well as the outcomes of specific antigen testing. The availabilities of specific antigen-negative blood components were calculated based on these registry data, and the prevalences of the various HEAs were predicted by genotyping. The prevalences of various red blood cell (RBC) antigens in the D-negative population were determined for the first time, and the Cartwright, Scianna, Dombrock, Colton, Landsteiner-Wiener, Cromer, and Knops blood group systems were identified. The availabilities of specific antigen-negative units differed when the calculations were based on serotyping or genotyping, especially in the D-negative group. Rare blood was defined as blood units without antigens that are prevalent in less than 1% of the population. According to the definition, Fya− blood, Dib− blood, and D− blood were defined as rare blood. In multiple antigen-negative blood, D+C−E− blood, D+c−e− blood, and S−s− blood were defined. In consideration of the multicenter registry, M− AND E− AND (Jka− and/or Jkb−) AND (Lea− and/or Leb−) blood were defined as rare blood. Data on the prevalences of various blood antigens are essential to estimate the availabilities of blood components that are appropriate for use by patients expressing relevant antibodies. Blood banks would then be able to efficiently supply safe blood products.