More detailed blood testing available for patients with disorders including sickle cell and thalassaemia, UK
Patients with blood disorders can now get detailed blood group typing to enable better matched and potentially safer transfusions.
NHS Blood and Transplant is now offering to genotype blood groups for those patients with haemoglobinopathies, which are disorders including sickle cell disease and thalassaemia that affect the body’s ability to make the oxygen carrying molecule haemoglobin.
The typing will also detect ‘Rh Variant’ blood groups, which are slightly different to other blood groups and need to be considered when planning transfusions. Previously, typing to this level would only be possible through reference laboratories using complex genotyping methods. Unlike the older phenotyping methods, NHS Blood and Transplant’s new, extended, testing can also be provided for people who have recently received blood.
NHS Blood and Transplant’s work will enable the creation of a database of genotyped blood details for patients in England with these disorders.
Extended blood type information, and fast access to the database, will potentially enable safer blood transfusions for patients with haemoglobin disorders, who may need numerous transfusions during their lifetime and who may move between hospitals. A sickle cell patient on a regular transfusion regimen might typically receive around 90 units of a blood a year.
Dr Sara Trompeter, NHS Blood and Transplant Consultant Haematologist, said: “Patients taking part can now potentially receive more finely matched blood if we know not just their blood group, but whether they have a variant Rh type. And there will also be greater safety and likelihood of getting matched blood in an emergency, as their records will be held centrally and can be accessed by blood banks in local hospitals.
“We would urge all patients with haemoglobin disorders such as, sickle cell disease or thalassaemia, to speak to their medical or nursing team about providing a blood sample to NHS Blood and Transplant via their local transfusion laboratories to be genotyped.”
Blood transfusions can result in red cell antibody formation – alloimmunisation – resulting in a patient developing an antibody to a blood group they don’t have naturally, usually in response to a blood transfusion. These antibodies can destroy donor blood and make it harder to transfuse the patient in the future. Alloimmunisation can be life threatening and around 25 per cent of people with haemoglobin disorders are affected by it.
Monica Korpal, 37, from Nottingham, has beta thalassaemia major, and needs two units of blood every three weeks. She has needed blood since she was 18 months old and has received hundreds of transfusions.
Monica, a married bank manager, welcomed the genotyping initiative. She said: “Getting the best matched blood every time is vital and it is really hard if you have to wait for a transfusion. The national database is a great idea. I’ve often worried about travelling and visiting people and other hospitals not having my information.”
Before the start of this initiative, only a small number of patients had their blood tested for Rh variant status. Around half of patients might have been tested for their basic blood phenotype, but that information would only have been stored at their local hospital. The initiative will test for a wider array of blood groups, including the most common Rh variant genes.
NHS Blood and Transplant is offering this testing at no extra cost to hospitals as part of the initiative until end of June 2016. More than 2,500 samples have been received so far, and it is hoped that many more samples from the estimated 15,000 people affected by haemoglobin disorders will be submitted before July. The results are processed centrally by NHS Blood and Transplant at the International Blood Group Reference Laboratory near Filton and securely stored. The results will be accessible to the teams who are involved in the future care of these patients.