Red cell molecular matching between autoimmune hemolytic anemia patients and blood donors

Abstract

Abstract Background Current blood-matching practices are challenging for patients with autoimmune hemolytic anemia (AIHA) because autoantibodies may interfere in hemagglutination assays. Blood group genotyping methods are an important complement to serology and allow the prediction of the phenotype from deoxyribonucleic acid (DNA) with high accuracy. Furthermore, technology for genotyping of red blood cell antigens in donor-recipient matching for blood group polymorphisms is moving into practice, mainly for patient groups with hemoglobinopathies. However, the routine use of antigen molecular matching for AIHA patients remains to be better determined. We hypothesized that performing the molecular matching between AIHA patients and blood donors could improve the selection of antigen-matched red blood cell units. Methods Using the blood-MLPA assay, we determined the blood group genotype from 198 donors and 24 AIHA patients and performed the RBC molecular matching between the two groups. Besides, using the hemagglutination technique we performed the RBC phenotyping for major blood group antigens of AIHA patients and compare the phenotyping with the genotyping results. Results: We were able to find RBC genotype-matched donors for 20/24 (83.3%) of our AIHA patients. From 118 phenotyping results, we found three (2.5%) discrepancies between the phenotype predicted by genotyping and the phenotype determined by serology. Conclusions In this study, our data indicate the real benefits of RBC genotyping for AIHA patients who usually present problematic immunohematological serologic reactions. Such a strategy may present information about additional RBC alloantibodies and reduce the potential risk of transfusion reactions.