The ability to determine a patient's antigen profile by DNA analysis when hemagglutination tests cannot be used is a useful adjunct to a serological investigation. Blood group genotyping in the transfusion setting is recommended for multiply transfused patients, as part of the antibody identification process.
Determination of a patient's blood type by DNA analysis is particularly useful when a patient who is transfusion-dependent has produced alloantibodies. This is because identification of the patient's probable pheno-type allows the laboratory to determine to which antigens the patient can and cannot respond to make alloantibodies.
We have demonstrated the relevance of genotype determination of blood groups for the management of multiply transfused patients with diseases such as sickle cell disease (SCD) and p-thalassemia[15,16] by allowing the determination of the true blood group genotype, and by assisting in the identification of suspected alloanti-bodies and the selection of antigen-negative RBCs for transfusion. Furthermore, we have observed that taking genotype into account allowed better selection of compatible units for patients with discrepancies between genotype and phenotype, leading to increased cell survival and a reduction of the transfusion frequency.
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