About 85 million units of red blood cells (RBCs) are transfused globally, and some patients requiring multiple transfusions are at a high risk of alloimmunization. Currently, serology is the gold standard for RBC phenotyping and matching. Recently, molecular methods utilizing DNA microarrays and single nucleotide polymorphism (SNP) genotyping have enabled large-scale typing, but these methods are incapable of identifying novel blood groups. Next-generation sequencing (NGS) technology may help to overcome these limitations. There are two such programs currently available to analyze sequencing data—BOOGIE and bloodTyper, but these programs require comprehensive immunogenetic and programming knowledge. Researchers in Australia have developed a third program with a novel algorithm called RBCeq (https://www.rbceq.org/) with a user-friendly, web-based interface that is easier to use. RBCeq can predict complex genotypes and phenotypes encompassing 36 blood groups made up of 1502 alleles. RBCeq was validated on 402 samples from diverse ethnic backgrounds, including 58 complex serology cases with published serology, SNP array, and NGS data. RBCeq predicted with 99.07% accuracy 97 antigens from 29 blood group systems. The algorithm also identified potential rare and novel variants. Future releases of RBCeq will include newly identified blood group systems and platelet antigens.
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