Blood grouping by molecular genetics

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It is possible to predict most clinically important blood group phenotypes from genomic DNA. Clinical applications include the following: determining foetal blood group to assess risk of haemolytic disease of the foetus and newborn or whether the pregnant woman requires antenatal anti-D prophylaxis; testing multiply transfused and autoimmune haemolytic anaemia patients; defining D variants; detecting donors with very weak D antigens; testing donors and patients when appropriate antisera are not available; RHD zygosity testing; zygosity testing of panel cells; assisting in solving difficult serological problems; and, with the use of high-throughput technologies, extended blood grouping of donors. Over the last 7 years, ISBT Workshops have provided external quality assurance. Future technologies may involve matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and massively parallel (next generation) sequencing.

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