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      Prevalence of Rh, Duffy, Kell, Kidd & MNSs blood group antigens in the Indian blood donor population

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          Abstract

          Background & objectives:

          Little data are available regarding the frequencies of the blood group antigens other than ABO and RhD in the Indian population. Knowledge of the antigen frequencies is important to assess risk of antibody formation and to guide the probability of finding antigen-negative donor blood, which is especially useful when blood is required for a patient who has multiple red cell alloantibodies. This study was carried out to determine the frequencies of the D, C, c, E, e, K, k, Fy a, Fy b, Jk a, Jk b, M, N, S and s antigens in over 3,000 blood donors.

          Methods:

          Samples from randomly selected blood donors from Delhi and nearby areas (both voluntary and replacement) were collected for extended antigen typing during the period January 2009 to January 2010. Antigens were typed via automated testing on the Galileo instrument using commercial antisera.

          Results:

          A total of 3073 blood samples from donors were phenotyped. The prevalence of these antigens was found to be as follows in %: D: 93.6, C: 87, c: 58, E: 20, e: 98, K: 3.5, k: 99.97, Fy a: 87.4, Fy b: 57.6, Jk a: 81.5, Jk b: 67.4, M: 88.7, N: 65.4, S: 54.8 and s: 88.7.

          Interpretation & conclusions:

          This study found the prevalence of the typed antigens among Indian blood donors to be statistically different to those in the Caucasian, Black and Chinese populations, but more similar to Caucasians than to the other racial groups.

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          Phenotype frequencies of blood group systems (Rh, Kell, Kidd, Duffy, MNS, P, Lewis, and Lutheran) in north Indian blood donors.

          Beenu Thakral, Karan Saluja, Ratti Sharma … (2010)
          We here report the first study of antigen and phenotype frequencies of various blood group systems by gel technology in north Indian blood donors. A total of 1240 regular repeat voluntary north Indian blood donors of O blood group were included for red cell antigen typing of Rh (D, C, E, c, e) and Kell (K) blood group systems. Out of these, 317 donors were randomly selected for typing of other blood group antigens: Jk(a), Jk(b), k, Kp(a), Kp(b), Fy(a), Fy(b), M, N, S, s, Le(a), Le(b), P(1), Lu(a), Lu(b) and Xg(a). Calculations of antigen and phenotypes frequencies were expressed as percentages and for allele frequencies under the standard assumption of Hardy-Weinberg equilibrium. Out of 1240 O group blood donors, 93.39% were Rh D and 5.56% were K positive. Amongst Rh antigens, e was the most common (98.3%) followed by D, C (84.76%), c (52.82%) and E (17.9%) with DCe/DCe (R(1)R(1), 43.8%) being the most common phenotype. In Kell blood group system, we found k antigen to be 100% and a rare phenotype Kp (a+b+) was found in 0.95% of the donors. For Kidd and Duffy blood group systems, Jk (a+b+) and Fy (a+b-) were the most common phenotypes (49.21% and 43.85%, respectively). In the MNS blood group system, M+N+S+s+ (19.55%) was the most common whereas M-N+S+s- (1.26%) was least common phenotype found. We found rare Lu (a+b+) and Lu (a-b-) phenotypes in 0.95% and 3.15% of the donors, respectively. Xg(a) antigen was seen in 86.67% and 62.6% of female and male donors, respectively. Knowledge of red cell antigen phenotype frequencies in a population is helpful in terms of their ethnic distribution, in creating a donor data bank for preparation of indigenous cell panels, and providing antigen negative compatible blood to patients with multiple alloantibodies. (c) 2010 Elsevier Ltd. All rights reserved.
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            Probability of anti-D development in D- patients receiving D+ RBCs.

            Lutz Dümbgen, Christoph Frohn, Matthias Brand … (2003)
            In some situations, the administration of D+ RBCs to D- patients is necessary. The probability of a subsequent anti-D formation is assumed to be around 80 percent, a figure based primarily on studies in healthy volunteers. It was hypothesized that patients requiring blood transfusion have a much lower probability of developing antibodies. A retrospective analysis was performed whereby 78 D- patients were evaluated for the development of RBC antibodies after administration of D+ RBCs. For the analysis of the cross-sectional observations, parametric models were used for interval-censored data. Anti-D was detected in 16 of 78 patients. Considering the individual patient's inspection times, the calculated probability of developing antibody following D+ RBC supply was shown to be below 41.7 percent (upper 95% confidence bound) and estimated as 30.4 percent. The data hinted toward an inverse correlation between the number of transfused units and the probability of antibody formation. Interestingly, 6 of these 16 patients developed additional IgG autoantibody. In 3 of those cases, evidence for prolonged hemolysis was found. The actual frequency of antibody formation in our patients is much lower than assumed. On the other hand, prolonged hemolysis probably induced by additional autoreactive antibodies might occur. This possible complication has not yet been addressed. Further studies might reveal whether a less restricted transfusion policy with respect to D matching is justified in selected patients.
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              MNS blood group system: a review.

              Corinne L. Reid (2008)
              The MNS blood group system is second only to the Rh blood group system in its complexity. Many alloantibodies to antigens in the MNS system are not generally clinically significant although antibodies to low-prevalence and high-prevalence MNS antigens have caused hemolytic disease of the fetus and newborn. The MNS antigens are carried on glycophorin A (GPA), glycophorin B (GPB), or hybrids thereof, which arise from single-nucleotide substitution, unequal crossing over, or gene conversion between the glycophorin genes. Antigens in the MNS system are fully developed at birth. This review summarizes aspects of the MNS system, including the molecular basis of some antigens in the MNS blood group system. Readers are referred to existing excellent reviews for background information. Throughout this document, information given without references can be found in the reviews listed previously, and the reader is referred to these reviews for references to original reports.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Indian J Med Res
                Journal ID (iso-abbrev): Indian J. Med. Res
                Journal ID (publisher-id): IJMR
                Title: The Indian Journal of Medical Research
                Publisher: Medknow Publications & Media Pvt Ltd (India )
                ISSN (Print): 0971-5916
                ISSN (Electronic): 0975-9174
                Publication date (Print): March 2013
                Volume: 137
                Issue: 3
                Pages: 521-526
                Affiliations
                [1] Department of Transfusion Medicine, Indraprastha Apollo Hospitals, New Delhi, India
                Author notes
                Reprint requests: Dr R.N. Makroo, Director, Department of Transfusion Medicine, Indraprastha Apollo Hospital, Sarita Vihar, Mathura Road, New Delhi 110 044, India e-mail: makroo@ 123456apollohospitals.com , raj_makroo@ 123456hotmail.com
                Article
                Publisher ID: IJMR-137-521
                PMC ID: 3705660
                PubMed ID: 23640559
                SO-VID: aae8e69d-3da2-4bee-8fae-5d932b698a79
                Copyright © Copyright: © The Indian Journal of Medical Research
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Subject: Original Article

                ScienceOpen disciplines: Medicine
                Keywords: abo,alloantibodies,blood group antigens,extended antigen typing
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: abo, alloantibodies, blood group antigens, extended antigen typing

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