An algorithmic approach to serological work-up of ABO sub-groups which present as ABO discrepancies in resource constraint settings.


Journal

Journal of immunological methods
ISSN: 1872-7905
Titre abrégé: J Immunol Methods
Pays: Netherlands
ID NLM: 1305440

Informations de publication

Date de publication:
12 2020
Historique:
received: 12 07 2019
revised: 11 03 2020
accepted: 06 10 2020
pubmed: 16 10 2020
medline: 2 3 2021
entrez: 15 10 2020
Statut: ppublish

Résumé

ABO subgroups or weaker variants of A or B are group A or B subjects whose erythrocytes give a weak or negative reaction serologically with anti-A or Anti - B antisera respectively. Occurrence of these subgroups may lead to an ABO discrepancy which often puts transfusion services in a quandary. ABO subgroups which present as ABO discrepancies can be missed if reverse grouping is not performed. This study was planned to estimate the prevalence of different subgroups which can present as an ABO discrepancy in Indian population, and provide an insight to transfusion services for identification of subgroups serologically. A cross-sectional, analytical study was performed at a tertiary healthcare based blood bank on whole blood donors and patients from January 2017 to July 2018. All suspected type II and Type IV (with Anti-A1) ABO discrepant samples were projected to an algorithmic testing process, to confirm discrepancy and then narrow down to the probable subgroup. A total of 33 subgroup discrepancies; 26 of A group and 7 of B group were identified out of 73,380 patient and 35,279 donor samples tested for blood grouping. Following the algorithm, the overall prevalence of weak subgroups which can present as an ABO discrepancy was found to be 1 in 3293 or 0.03% in our population by serological testing. Out of the discrepancies caused by subgroups, the prevalence of subgroups of A were 0.0101%, 0.0018%, 0.0009%, 0.0027%, 0.0027% and 0.0018% for A2 with anti-A1, A3, Aend, Ax, Am and Ael respectively while those of B were 0.009%, 0.0009%, 0.0009% and 0.009% for B3, Bx, Bm and Bel respectively. Algorithmic approach for resolution of ABO discrepancies caused by subgroups helps in identifying the subgroup which is important because these individuals may be mistyped as group O individuals.

Sections du résumé

BACKGROUND
ABO subgroups or weaker variants of A or B are group A or B subjects whose erythrocytes give a weak or negative reaction serologically with anti-A or Anti - B antisera respectively. Occurrence of these subgroups may lead to an ABO discrepancy which often puts transfusion services in a quandary. ABO subgroups which present as ABO discrepancies can be missed if reverse grouping is not performed.
AIM
This study was planned to estimate the prevalence of different subgroups which can present as an ABO discrepancy in Indian population, and provide an insight to transfusion services for identification of subgroups serologically.
MATERIALS AND METHODS
A cross-sectional, analytical study was performed at a tertiary healthcare based blood bank on whole blood donors and patients from January 2017 to July 2018. All suspected type II and Type IV (with Anti-A1) ABO discrepant samples were projected to an algorithmic testing process, to confirm discrepancy and then narrow down to the probable subgroup.
RESULTS
A total of 33 subgroup discrepancies; 26 of A group and 7 of B group were identified out of 73,380 patient and 35,279 donor samples tested for blood grouping. Following the algorithm, the overall prevalence of weak subgroups which can present as an ABO discrepancy was found to be 1 in 3293 or 0.03% in our population by serological testing. Out of the discrepancies caused by subgroups, the prevalence of subgroups of A were 0.0101%, 0.0018%, 0.0009%, 0.0027%, 0.0027% and 0.0018% for A2 with anti-A1, A3, Aend, Ax, Am and Ael respectively while those of B were 0.009%, 0.0009%, 0.0009% and 0.009% for B3, Bx, Bm and Bel respectively.
CONCLUSION
Algorithmic approach for resolution of ABO discrepancies caused by subgroups helps in identifying the subgroup which is important because these individuals may be mistyped as group O individuals.

Identifiants

pubmed: 33058890
pii: S0022-1759(20)30189-7
doi: 10.1016/j.jim.2020.112895
pii:
doi:

Substances chimiques

ABO Blood-Group System 0
Antibodies 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

112895

Informations de copyright

Copyright © 2020 Elsevier B.V. All rights reserved.

Auteurs

Aseem K Tiwari (AK)

Department of Transfusion Medicine, Medanta-The Medicity, Sector-38, Gurgaon 122001, India.

Divya Setya (D)

Department of Transfusion Medicine, Medanta-The Medicity, Sector-38, Gurgaon 122001, India. Electronic address: setyadivya@gmail.com.

Dinesh Arora (D)

Department of Transfusion Medicine, Medanta-The Medicity, Sector-38, Gurgaon 122001, India.

Swati Pabbi Mehta (SP)

Department of Transfusion Medicine, Medanta-The Medicity, Sector-38, Gurgaon 122001, India.

Geet Aggarwal (G)

Department of Transfusion Medicine, Medanta-The Medicity, Sector-38, Gurgaon 122001, India.

Subhasis Mitra (S)

Department of Transfusion Medicine, Medanta-The Medicity, Sector-38, Gurgaon 122001, India.

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