Main Article Content
Blood group antigens –Phenotype – alloimmunisation- Indian Tribal population, Multitransfused patients – Sickle cell anemia.
Background:Sickle cell anaemia is common amongst Tribal population of south Gujrat. Alloimmunisation in multitransfused sickle cell anaemia patient is 10 times commoner in these patients than beta Thalassemia major patients from regular blood donor communities.
Study design & methodology: Red cell antigen typing of Rh (D,C,E,c,e ), Kell (K, k), Duffy (Fya, Fyb) and Kidd (Jka, Jkb) were carried out in 222 regular voluntary blood donors who belonged to non-tribal population and in 113 samples of tribal population using conventional antisera.
Results: Rh D antigen frequency was 96.6% in non-tribal and 96.5% in tribal population. 2.4% of K antigen was found in non-tribal population whereas the antigen was absent in tribal population .Amongst Rh antigens, e was the most common (100%) followed by D, C (91.0%, 85.8%), c (50.5%, 44.2%) and E (16.5%, 17.0%) with DCe/DCe (R1R1, 48.0%, 55.8%) being the most common phenotype in both the groups. In Kell antigens k antigen was 100% ,Kidd and Duffy antigens Jk (a+b-) (39.2%, 46.9%) and Fy (a+b-) (64.2%, 52.2%) were the most common phenotypes in non-tribal and tribal population respectively.
Conclusion: There is significant difference in Duffy , Kidd and Kell (k) antigen distribution between non tribal and tribal population . Total absence of Kell antigen in tribalsalong with. E antigen in a significant portion of blood donors and its absence in large number of tribals also increase the risk of alloimmunisation.
. Chou ST. Transfusion therapy in sickle cell disease : a balancing act. Am Soc Hematol Educ Program. 2013;2013:439-46.
. Thakral B, Saluja K, Marwaha N, Sharma RR. Red cell alloimmunization in transfused patient population: a study from a tertiary care hospital in north India. Hematology 2008;13:313–8.
. Olujohungbe A, Hambleton I, Stephens L, Serjeant B, Serjeant G. Red cell antibodies in patients with homozygous sickle cell disease: a comparison of patients in Jamaica and the United Kingdom. Br J Haematol. 2001 ;113 :661-5.
. Natukunda B, Schonewille H, Ndugwa C, Brand A. Red blood cell alloimmunization in sickle cell disease patients in Uganda. Transfusion. 2010 ;50:20-5.
Thakral B, Saluja K, Sharma RR, Marwaha N. Phenotype frequencies of blood groups systems (Rh, Kell, Kidd, Duffy, MNS,P, Lewis, and Lutheran) in north Indian blood donors. TransfusApher Sci 2010; 43:17-22.
.Kahar MA, Patel RD: Phenotype frequencies of bloodgroup systems (Rh, Kell, Kidd, Duffy, MNS, P, Lewis,and Lutheran) in blood donors of south Gujarat, India.Asian J Transfus Sci 2014; 8: 51–55.
.Basu D. Dutta SS, Montemayor C, Bhattacharya P, Mukharjee K, Flegel WA. ABO, Rhesus, and Kell antigens, alleles, and haplotypes in West Bengal, India. Transfus Med emother 2018; 45: 62-66.
.Bhatia HM, Rao VR. Genitics atlas of the Indian Tribes. Institute of Immunohaematology (ICMR) Bombay 1986.
.Nanu A, Thapliyal R. Blood group gene frequency in a selected north Indian population. Indian J Med Res. 1997;106:242-6.
.Patel AG, Shah AP, Sorathiya SM, Gupte SC. Hemoglobinopathies in South Gujarat population and incidence of anemia in them. Indian J Human Genet 2012. 18 294-98.
. Jariwala K, Mishra K , Ghosh K .Comparative Study of alloimmunisation against redcell antigens in sickle cell disease and thalassaemia major patients on regular redcell transfusion. Ind J Med Res ( accepted ).
. Grossmann Bt, Hillyer CD, Westhoff CM ( eds ) AABB. Technical manual. 2014;18th ed. AmericanAssociation of Blood Banks; Bethesda USA.
. Colah RB, Mukherjee MB, Martin S, Ghosh K.Sickle cell disease in tribal populations in India.Indian J Med Res. 2015 ;141:509-15.
 Denise M. Harmening. Modern blood banking and transfusion practices. 5th ed. Philadelphia: FA Davis Company; 2005. p. 163-90.
.Daniels G. Human blood groups. 2nd ed. Oxford: Blackwell Scienc Publications; 2002. p. 7-348.
.Sally V. Rudmann. Blood Banking and Transfusion Medicine. 2nd ed.Philadelphia: Elseiver Saunders; 2005. p. 86-146.
.Reid ME, Lomas-Francis C. The blood group antigen facts book.2nd ed. London: Elsevier Academic Press; 2004. p. 29-296.