Surprisingly, in our study seven of 36 (19%) antibodies were against low frequency African antigens ( em i.e. /em , Goa 2%, RH32 1%, He 1% and Dantu 0.5% in Africans).1 This suggests that these antigens are immunogenic in Ghanaians and may be more immunogenic than antigens for which we test in the Western setting. of RBC antibodies against Caucasian and African antigens in multi-transfused individuals with SCD in Ghana, where pre-transfusion antibody testing and indirect antiglobulin crossmatch are not routine. Our cross-sectional study recruited individuals between July and December 2018, from two tertiary private hospitals. Patients were eligible for inclusion if they were at least 2 years of age and experienced received Roflumilast N-oxide at least two transfusions at least 6 weeks before study enrolment (to allow time to develop antibodies). Individuals were episodically transfused with non-leucoreduced Roflumilast N-oxide whole blood from African donors. Donors were not screened for sickle cells. Participants demographics and transfusion history were retrieved from hospital documents. Individuals or caretakers offered this information, if missing from hospital documents, using a standard questionnaire. Plasma and buffy coating samples, taken at enrolment, were freezing at C80C and transferred to Sanquin, Amsterdam, the Netherlands, for routine antibody screening against a standard three-cell reagent panel (Bio-Rad Laboratories AG, Cressier, Switzerland), not expressing antigens that are more common in Africans, using a low ionic strength answer (LISS) indirect anti-globulin gel column agglutination test. Using the same method, antibody recognition was performed with commercial panels of reagent RBC of selected phenotypes and against eight selected cells with antigens that are very rare ( 0.01% to 1%) in Caucasians but more frequent (0.5% to 32%) in Africans (genotyping Roflumilast N-oxide was carried out on genomic DNA by Multiplex Ligation-dependent Probe Amplification (MLPA) assay according to the manufacturers protocol (MRC Holland, Amsterdam, the Netherlands) using a thermocycler (Veriti, Applied Biosystems, Nieuwerkerk aan de IJssel, the Netherlands).2 When MLPA results were equivocal, DNA sequencing was performed to determine the genotype. Sequence products were analyzed on a genetic analyzer (3730xl, Applied Biosystems). Table 1. Specificities of the 36 reddish blood cell antibodies in the 35 alloimmunized multi-transfused Ghanaian individuals Roflumilast N-oxide with sickle cell disease. Open in a separate windows The study was authorized by the Committee on Human being Study, Publication and Ethics, Kwame Nkrumah University or college of Technology and Technology, and Korle Bu Teaching Hospital and Liverpool School of Tropical Medicine Institutional Review Boards. Individuals or their caretakers offered written educated consent to participate in the study. Statistical analyses were performed using the SPSS (IBM Corp., Armonk, NY, USA). Results for continuous variables were offered as medians (range) and categorical variables as frequencies (percentages). We recruited 221 Ghanaian individuals (123 ladies and 98 males; 89% hemoglobin [Hb] SS, 10% HbSC, one HbSD and one HbSb0-thalassemia). The median age at enrolment was 17 years (range, 2-66 years). Individuals experienced received a median of three (range, 2-40) whole blood transfusions and the median period between last transfusion and study enrolment was 2.1 years (range, 6 weeks to 55.5 years). Antibody screening, using standard test cells, was positive in 24 individuals (10.9%) and revealed 25 antibody specificities (Table 1). Although D antigen coordinating CLTB was routine in Ghana, anti-D was present in seven individuals. genotyping of these individuals exposed that three ladies and two males had only and one genes (and em RHD*04.01 /em ) connected with D+ serology and service providers of these variants can help to make anti-D after D-antigen exposure.3,4 The nine individuals with D, G and s antibodies and the three individuals with pan-reactive antibodies, were not tested against the African antigens because African test cells lacking these antigens were not available. Of the remaining 209 individuals, eleven (5.3%) individuals who did not possess alloantibodies against the standard three-cell screen panel, had a total of eleven antibodies against African antigens; three anti-Dantu (for one, confirmation by a second Dantu+ test cell was not performed, due to lack of Dantu+ cells), two anti-He, two anti-V/VS, one anti-VS, one anti-RH32, one anti-Goa and one antibody probably against a low rate of recurrence antigen but no plasma was available for further.
