RESUMO
Background@#The Korean Red Cross has conducted serologic tests for C, c, E, e antigens and found 18 D-- donors.In this study, we performed RHCE genotyping to identify the molecular characteristics of the serologic D-- blood type in Korean blood donors. @*Methods@#We performed RHCE-specific PCR-based electrophoresis to check the amplification pattern of each exon.Sanger sequencing was conducted to find the variants in the nucleotide sequence. We determined the RHCE genotype based on the electrophoresis and Sanger sequencing results. @*Results@#Total eight out of 18 D-- donors were participated in this research. In the PCR-based electrophoresis tests, RHCE exons 3, 4, and 6 were not amplified in samples #4, #6, and #8. Also, sample #2 showed an abnormal band pattern of RHCE exon 9. The Sanger sequencing results showed that the nucleotide sequences of the RHCE exons 5, 7, and 8 in samples #4, #6 and #8 corresponded to the nucleotide sequences of RHD exons 5, 7, and 8, respectively, suggesting the possibility of a RHCE-RHD(3-8)-RHCE hybrid allele. The nucleotide sequences of RHCE exons 7 and 8 in sample #2 were the same as the nucleotide sequences of RHD exons 7 and 8, respectively.In samples #1, #3, #5, and #7, no specific variants known to cause D-- phenotype were found. @*Conclusion@#RHCE genes partially replaced by the RHD genes were found in four out of eight participants and three of them were identified as ?RHCE*02N.07, which is known as the RHCE null allele. A further study with complete RHCE sequencing could be helpful for an understanding of the molecular mechanisms of samples in which no significant variants were identified.
RESUMO
HLA-matched platelet transfusion is required for patients with platelet refractoriness due to HLA alloimmunity. From 2013 to 2019, the Korean Red Cross has recruited 4,080 donors for HLA-matched platelets. The patient’s HLA information should be submitted to the Korean Red Cross in accordance with the WHO HLA serologic specificities. When HLA-matched platelets are requested, the Korean Red Cross selects the appropriate donors based on Duquesnoy’s matching grade classification (1977) and CREGs defined by Takemoto, Fuller, and Rodey (2007) and then contacts them to request blood donations. Platelets of HLA-matched donors are collected by apheresis and supplied to the hospital. To make this process more efficient, the Korean Red Cross introduced a systemic standard work procedure using a computer program for blood donor management and HLA matching. Owing to the extensive polymorphism of the HLA types, expansion of the donor pool would be required to supply HLA-matched platelets sufficiently. As the number of registered donors for HLA-matched platelets is limited, it should only be ordered when the indication criteria for its use are met. The Korean Red Cross is planning to study genotype-based matching strategies for patients with rare HLA types and receive patients’ laboratory test results from medical institutions to evaluate the effectiveness of HLA-matched platelet transfusions.
RESUMO
HLA-matched platelet transfusion is required for patients with platelet refractoriness due to HLA alloimmunity. From 2013 to 2019, the Korean Red Cross has recruited 4,080 donors for HLA-matched platelets. The patient’s HLA information should be submitted to the Korean Red Cross in accordance with the WHO HLA serologic specificities. When HLA-matched platelets are requested, the Korean Red Cross selects the appropriate donors based on Duquesnoy’s matching grade classification (1977) and CREGs defined by Takemoto, Fuller, and Rodey (2007) and then contacts them to request blood donations. Platelets of HLA-matched donors are collected by apheresis and supplied to the hospital. To make this process more efficient, the Korean Red Cross introduced a systemic standard work procedure using a computer program for blood donor management and HLA matching. Owing to the extensive polymorphism of the HLA types, expansion of the donor pool would be required to supply HLA-matched platelets sufficiently. As the number of registered donors for HLA-matched platelets is limited, it should only be ordered when the indication criteria for its use are met. The Korean Red Cross is planning to study genotype-based matching strategies for patients with rare HLA types and receive patients’ laboratory test results from medical institutions to evaluate the effectiveness of HLA-matched platelet transfusions.