A Review on Discrepancy of ABO Blood Grouping, Distribution of Causes in Iran and the World, and Resolving Methods

Document Type : Review Article

Authors

1 Department of Immunology, School of Medicine AND Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

2 PhD Student, Department of Clinical Biochemistry and Laboratories, School of Medicine AND Umbilical Cord Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

3 Assistant Professor, Department of Laboratory Hematology and Blood Banking, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran

Abstract

Background: ABO blood grouping is the most important test that should be examined before blood transfusion. Transfusion of ABO incompatible blood leads to acute hemolytic reactions, malignant disease and in severe and uncontrolled cases might cause death.Methods: Direct or forward blood grouping or cell typing (i.e. investigation of antigens on erythrocytes surface) and indirect grouping or reverse typing (i.e. investigation of serum antibodies) are the most common tests to determine blood groups in laboratory. Interpretation and compatibility of the results from blood grouping tests (cell typing and reverse typing) is a crucial step to decide and perform blood transfusion. In case of incompatible results of direct and indirect blood grouping, additional tests must be performed before reporting the results and in emergency blood transfusion situations, O+ RBCs should be used. In this manuscript, we reviewed and summarized factors involved in ABO blood group discrepancies. We studied reports in this context in Iran and the world and compared the most frequent incompatibility factors in Iran in comparison to the rest of the world. Finally, we suggested plausible methods which could be taken into account to lower the risk of incompatible blood transfusion in Iran.Conclusion: Technical and clerical errors in Iran and the world, respectively, are reported to be the most common cause of ABO discrepancy. This result indicates different nature of ABO discrepancy factors between Iran and other countries. Understanding these differences is the very first step to improve blood donation and transfusion procedures locally and that requires long-term extensive domestic investigations.

Keywords


  1. Landsteiner K. The specificity of serological reactions. New York, NY: Dover Publications; 1990.
  2. Rudmann SV. Textbook of blood banking and transfusion medicine. 2nd ed. Philadelphia, PA: Saunders; 2005.
  3. Spalter SH, Kaveri SV, Bonnin E, Mani JC, Cartron JP, Kazatchkine MD. Normal human serum contains natural antibodies reactive with autologous ABO blood group antigens. Blood 1999; 93(12): 4418-24.
  4. Filitti-Wurmser S. Natural antibodies and immune antibodies of human ABO blood group system. Biochimie 1976; 58(11-12): 1345-53.
  5. Blaney KD, Howard PR. Basic and applied concepts of immunohematology. 2nd ed. Philadelphia, PA: Mosby; 2008.
  6. Moayedi-Esfahani B. Clinical blood transfusion and lab methods. Isfahan, Iran: Neshat Publications; 1989. [In Persian].
  7. Chiaroni J, Legrand D, Dettori I, Ferrera V. Analysis of ABO discrepancies occurring in 35 French hospitals. Transfusion 2004; 44(6): 860-4.
  8. Mohammadi S, Dargahi H, Alizadeh S, Farshdusti-Hagh M, Dejhbakhsh E. Agglutination tests quality control in hematology labs. Physician and Laboratory Journal 2010; 9(44): 7-10. [In Persian].
  9. Linden JV, Wagner K, Voytovich AE, Sheehan J. Transfusion errors in New York State: an analysis of 10 years' experience. Transfusion 2000; 40(10): 1207-13.
  10. Kaplan HS, Battles JB, Van der Schaaf TW, Shea CE, Mercer SQ. Identification and classification of the causes of events in transfusion medicine. Transfusion 1998; 38(11-12): 1071-81.
  11. Alizadeh S, Farshdusti-Hagh M. Blood collection, handling and storage. Physician and Laboratory Journal 2008; 7(36): 17-21. [In Persian].
  12. Henry JB. Clinical diagnosis and management by laboratory methods. Philadelphia, PA: Saunders; 2001.
  13. Walker RH. AABB technical manual. 10th ed. Arlington, VA: American Association of Blood Banks; 1990.
  14. Farshdusti-Hagh M, Noruzinia M, Saki N. The importance of quality control in the preanalytical phase. Proceedings of the 2nd International and 7th National Congress on Quality Improvement in Clinical Laboratories; 2009 Apr 21-24; Tehran, Iran.
  15. Meade D, Stewart J, Moore BP. Automation in the blood transfusion laboratory. II. ABO grouping, Rh and Kell typing, antibody screening, and VD testing of blood donations in the autoanalyzer. Can Med Assoc J 1969; 101(9): 35-9.
  16. Chiaroni J, Lauroua P, Roubinet F, Mannessier L. Problem-solving in immunohematology: interpretation of ABO typing and its difficulties. Transfus Clin Biol 2000; 7(1): 84-95.
  17. Flynn JC. Essentials of immunohematology. Philadelphia, PA: Saunders; 1998.
  18. Golafshan H, Ghahremani MH, Sharifzadeh S. Lab principals in blood bank. Shiraz, Iran: Shiraz University of Medical Sciences; 1999. [In Persian].
  19. Myhre BA. Fatalities from blood transfusion. JAMA 1980; 244(12): 1333-5.
  20. Harmening D, Calhoun L, Polesky HF. Modern blood banking and transfusion practices. 5th ed. Philadelphia, PA: FA Davis; 2005.
  21. Klein HG, Anstee DJ. Mollison's blood transfusion in clinical medicine. 11th ed. Hobken, NJ: Wiley; 2008.
  22. Sazama K. Reports of 355 transfusion-associated deaths: 1976 through 1985. Transfusion 1990; 30(7): 583-90.
  23. Rouger P, Le Pennec PY, Noizat-Pirenne F. Immunologic risk analysis of blood transfusion: 1991-1998. Transfus Clin Biol 2000; 7(1): 9-14.
  24. Selseleh M, Esmaeeli J. Evaluation of ABO group discrepancies in Tehran blood transfusion center, 2002 to 2003. Blood Transfusion Bulletin of North Central Region 2010; 53: 1-6. [In Persian].
  25. Rahgozar S, Yavari FM, Hariri MM, Moafi AR. ABO discrepancy prevalence and qualitative study of relevant factors in blood donors of Isfahan Regional Blood Transfusion Center. Sci J Iran Blood Transfus Organ 2006; 3(1): 53-62. [In Persian].
  26. Judd WJ. Microbial-associated forms of polyagglutination (T, Tk and acquired-B). In: Beck ML, Judd WJ, editors. Polyagglutination, a technical workshop. Washington, DC: American Association of Blood Banks; 1980.
  27. Judd WJ, Annesley TM. The acquired-B phenomenon. Transfus Med Rev 1996; 10(2): 111-7.
  28. Marsh WL. The pseudo B antigen. A study of its development. Vox Sang 1960; 5: 387-97.
  29. Stratton F, Renton PH. Acquisition of B-like Antigen. Br Med J 1959; 2(5146): 244.
  30. Williamson P, Springer GF. Blood-group B active somatic antigen of E. coli O86:B7. Fed Proc 1959; 18: 604.
  31. Gerbal A, Maslet C, Salmon C. Immunological Aspects of the Acquired B Antigen. Vox Sanguinis 1975; 28(5): 398-403.
  32. Cameron C, Graham F, Dunsford I, Sickles G, Macpherson CR, Cahan A, et al. Acquisition of a B-like antigen by red blood cells. Br Med J 1959; 2(5140): 29-32.
  33. Giles CM, Mourant AE, Parkin DM, Horley JF, Tapson KJ. A weak B antigen, probably acquired. Br Med J 1959; 2(5140): 32-4.
  34. Farshdusti-Hagh M, Noruzinia M. Diagnostic values of diseases by using peripheral blood. Proceedings of the 2nd International and 7th National Congress on Quality Improvement in Clinical Laboratories; 2009 Apr 21-24; Tehran, Iran.
  35. Wilson JA, Jacobs A. ABO discrepancy in a multiple myeloma patient: a case study. Clin Lab Sci 2002; 15(4): 204-7.
  36. Landsteiner K. The nature and specificity of antibodies: the specificity of serological reactions. Cambridge, MA: Harvard University Press; 1945. p. 127.
  37. Park TS, Oh SH, Choi JC, Kim HH, Park JH, Lee EY, Son HC. A Case of agammaglobulinemia detected by ABO discrepancy in a 13-year-old girl. Korean J Lab Med 2002; 22(5): 364-6.
  38. Oh SH, Kang CI, Kim J, Park TS. ABO discrepancy in a young Korean serviceman with common variable immunodeficiency. Ann Hematol 2010; 89(6): 629-30.
  39. Kim SY, Oh SH, Park KS, Kim MJ, Lim G, Cho SY, et al. ABO discrepancy in an elderly patient with IgA kappa-type multiple myeloma. Ann Hematol 2010; 89(7): 747-8.
  40. Deng ZH, Zeng JQ, Yu Q, Su YQ, Liang YL, Lu L, et al. Genotyping of samples lacking expected antibodies in ABO blood group. J Clin Lab Anal 2007; 21(6): 363-6.
  41. Daniels G. Human blood groups, 2nd ed. Oxford, UK: Blackwell Scientific; 2002. p. 52.
  42. Yazer MH, Hosseini-Maaf B, Olsson ML. Blood grouping discrepancies between ABO genotype and phenotype caused by O alleles. Curr Opin Hematol 2008; 15(6): 618-24.
  43. Wagner FF, Blasczyk R, Seltsam A. Nondeletional ABO*O alleles frequently cause blood donor typing problems. Transfusion 2005; 45(8): 1331-4.
  44. Mizuno N, Ohmori T, Sekiguchi K, Kato T, Fujii T, Fujii K, et al. Alleles responsible for ABO phenotype-genotype discrepancy and alleles in individuals with a weak expression of A or B antigens. J Forensic Sci 2004; 49(1): 21-8.
  45. Michino J, Hata Y, Matsui K, Takizawa H, Kominato Y, Tabata S, et al. Demonstration of A antigen and A allele of ABO histo-blood group in nail in a case with the absence of A antigen and anti-A antibody in blood. Leg Med (Tokyo) 2005; 7(3): 194-7.