Shao Chao-Peng, Zhao Cheng-Jiang, Wu Chang-Lin, Xu Hua, Wang Xue-Dong, Wu Xiao-Ying, Yi Ping, Dang Xin-Tang
Department of Blood Transfusion, The First Affiliated Hospital of Shenzhen University School of Medicine, The Second People's Hospital of Shenzhen, Shenzhen, China.
Institute of Translational Medicine, The First Affiliated Hospital of Shenzhen University School of Medicine, The Second People's Hospital of Shenzhen, Shenzhen, China.
Transfus Med Hemother. 2018 Jul;45(4):252-257. doi: 10.1159/000489471. Epub 2018 Jul 5.
Molecular typing for blood group alleles has been established in many countries for patients and blood donors. In the Chinese literature nearly 80% of transfused patients with alloimmunization have antibodies specific for antigens of the Rh blood group system. We investigated if it is feasible to match packed red blood cells (RBCs) for Chinese β-thalassemia patients by genotyping.
In this study, 481 patients with β-thalassemia were enrolled. They were genotyped for alleles by a simple PCR method with sequence-specific primers (PCR-SSP). Among these patients, 203 continuously received RBCs of the identical Rh subgroups according to the genotyping results for at least 3 months. Subsequently, their phenotypes were tested through a micro-column gel card method. For validation purposes, 400 donors were serologically typed with the same technology, of which 164 were genotyped too. Finally, the C, c, E, and e frequencies and the feasibility of the simple genotyping method were analyzed.
All patients showed mixed-field agglutination in the Rh subgroup gel cards before the same Rh subgroups in blood donors were selected for blood transfusion. The results, however, lacked mixed-field agglutination in all 203 cases after transfusion with RBC concentrates selected for the patient's C, c, E, and e antigens for at least 3 months. The genotyping results of 164 donors were all consistent with the serological results. Whole coding regions of were sequenced in 7 individuals with weak c, E, or e antigens. In only one sample we observed a 1059G>A nucleotide mutation coding for a truncated RhCE polypeptide (GenBank KT957625), in the other 6 samples no sequence variant was found. Both patients and donors were predominantly CcEe and CCee, with a prevalence of 55.3% and 24.9% for patients or 49.3% and 31.3% for donors, respectively. It revealed that about 80% of Chinese could receive Rh-matched RBCs easily.
A simple genotyping technique is safe enough for Rh-matched transfusion of β-thalassemia patients in Chinese Han.
许多国家已为患者和献血者建立了血型等位基因的分子分型方法。在中国文献中，近80%的发生同种免疫的输血患者具有针对Rh血型系统抗原的特异性抗体。我们研究了通过基因分型为中国β地中海贫血患者匹配浓缩红细胞（RBC）是否可行。
本研究纳入了481例β地中海贫血患者。采用序列特异性引物的简单PCR方法（PCR-SSP）对其等位基因进行基因分型。在这些患者中，203例根据基因分型结果连续至少3个月接受相同Rh亚组的RBC。随后，通过微柱凝胶卡法检测他们的表型。为进行验证，对400名献血者采用相同技术进行血清学分型，其中164名也进行了基因分型。最后，分析了C、c、E和e基因频率以及简单基因分型方法的可行性。
在为患者选择献血者相同Rh亚组进行输血前，所有患者在Rh亚组凝胶卡中均显示混合视野凝集。然而，在输注针对患者C、c、E和e抗原选择的RBC浓缩物至少3个月后，所有203例患者的结果均未出现混合视野凝集。164名献血者的基因分型结果均与血清学结果一致。对7例具有弱c、E或e抗原的个体的整个编码区进行了测序。仅在一个样本中观察到编码截短RhCE多肽的1059G>A核苷酸突变（GenBank KT957625），在其他6个样本中未发现序列变异。患者和献血者主要为CcEe和CCee，患者的患病率分别为55.3%和24.9%，献血者的患病率分别为49.3%和31.3%。结果显示，约80%的中国人可以轻松接受Rh匹配的RBC。
一种简单的基因分型技术对于中国汉族β地中海贫血患者的Rh匹配输血足够安全。
