When the available blood supply mismatches the needs of the patient

Abstract

Background - Substantial regional differences in the genetic patterns related to blood group have been observed across different continents. This diversity means that the blood supply, as an essential part of patient care, is increasingly impacted by global migration.  Consequently, the Austrian blood donor population does not match the immigrant patient population. This mismatch is likely to result in the formation of alloantibodies to red cell antigens in the chronically transfused. Subsequently, major difficulties in providing compatible blood emerge.
Material and methods  - The study included patients of African origin (n=290) and Caucasians who represent the Austrian donor population (n=1,017). Genetic typing was performed for up to 69 blood group polymorphisms with a multiplex sequence specific primer-PCR including high frequency antigens and antigens for which antisera are not commercially available. By assessing differences in antigen frequencies between the two populations, and using these data for prophylactic matching, we aim to develop tools to increase the quality of patient care.
Results - Results indicate various and significant differences (p<0.0001) in antigen frequencies between African patients and the European donor population, especially in the MNS, Duffy, Knops and Rhesus systems.
Discussion - Our data highlight the importance of matching the donor population to the demographics of the patient population. In addition, it underlines the need to recruit donors of African origin and to focus on the upcoming challenges, such as malaria semi-immunity and a significantly higher rate of infectious disease in this population. It is also recommended to apply extended genetic typing to detect rare blood types, and (cryo)storage of rare blood in national and international rare blood banks. Co-operation with regional blood banks should also be encouraged.