Alloimmunization to red blood cell (RBC), human leukocyte (HLA), and human platelet (HPA) antigens can lead to hemolytic transfusion reactions and lower increments. Researchers with the Blood Transfusion Genomics Consortium have developed a high-throughput, genome-wide blood donor antigen typing system to analyze 48 RBC, HLA, and HPA antigens with 9,180 coding variants for approximately $40 per sample (including equipment, labor, and analysis). Using this array-based system, Applied Biosystems UK Biobank version 2 Axiom Array (UKBBv2 array), and the previously published bloodTyper algorithm, antigen typing data was generated for 7,984 blood donors from Europe, Asia and Africa. These donors had already been typed by the National Health Service Blood and Transplant and Sanquin and by serological phenotyping systems. Array genotyping results were 99.91%, 99.97%, and 99.03% concordant with the serological phenotyping results for RBCs, HPA, and HLA, respectively, increasing the number of matching donors for complex patients with multiple alloantibodies 2.6-fold. Further validation of the array is required, particularly in non-European populations, but the system could dramatically improve options for transfusion recipients.
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