Flegel Willy A
Institute of Transfusion Medicine, University Hospital Ulm, Germany.
Transfusion. 2007 Jul;47(1 Suppl):47S-53S. doi: 10.1111/j.1537-2995.2007.01310.x.
Molecular methods for blood group genotyping became available more than 10 years ago as one major aspect of immunogenetics. Since then, the clinical applications have been expanded and refined. Their implementation varies considerably among different health-care systems, notably between North America and Europe.
This summary is based on studies published mostly during the last 3 years and on workshop reports from the German and Swiss transfusion societies. It represents an edited transcript of the author's presentation given at the Workshop on Molecular Methods in Immunohematology organized by the Food and Drug Administration (FDA) in Bethesda on September 25, 2006.
Current applications of blood group genotyping in Germany, Switzerland, and Austria are detailed: weak D testing in patients and pregnant women; blood group genotyping in perinatal care, in patients who received a transfusion, and in patients with immunohematologic problems; RHD genotyping in donors for DEL and D(+/-) chimera; and RHD zygosity testing.
Since around 2000, molecular tests for blood groups have been widely offered as a routine service. Many samples are shipped to reference laboratories in the German-speaking countries with the specific request for such testing. The advent of Conformité Européenne (CE)-labeled test kits renders it technically and legally possible, within the specifications of the CE-certification process for in vitro diagnostic devices in the European Union, to replace several blood group serology tasks by genotyping.
血型基因分型的分子方法在10多年前就已成为免疫遗传学的一个主要方面。从那时起,其临床应用得到了扩展和完善。不同医疗体系之间其应用差异很大,尤其是在北美和欧洲之间。
本综述基于过去3年发表的研究以及德国和瑞士输血协会的研讨会报告。它是作者在2006年9月25日由美国食品药品监督管理局(FDA)在贝塞斯达组织的免疫血液学分子方法研讨会上发言的编辑记录。
详细介绍了血型基因分型在德国、瑞士和奥地利的当前应用:对患者和孕妇进行弱D检测;在围产期护理、接受输血的患者以及有免疫血液学问题的患者中进行血型基因分型;对献血者进行RHD基因分型以检测DEL和D(+/-)嵌合体;以及RHD纯合性检测。
自2000年左右以来,血型分子检测已作为一项常规服务广泛提供。许多样本被送往德语国家的参考实验室,并提出进行此类检测的特定要求。欧洲合格认证(CE)标记检测试剂盒的出现,在欧盟体外诊断设备CE认证过程的规范范围内,使得通过基因分型取代多项血型血清学检测在技术和法律上成为可能。