Work Package 1:
Blood Antigen Genotyping
At present, blood group types are determined by tests that use antibodies. A different test is required for every blood group type. There are many different blood group types and to test them all using antibodies is cumbersome and expensive. Consequently, at present only 1 in 6 NHSBT donors have most of their blood group types determined. If we are to take all blood group types into account when matching patients to donated blood then we need to be able to measure all the blood group antigens of patients and of the vast majority of the million donors.
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It is now possible to work out a person’s blood group types by testing his or her DNA. Although humans have approximately 20,000 genes, less than 50 of these determine blood group types. Before now measuring variation in blood type genes has been expensive and slow. However, a major advance has been made by the Blood transfusion Genomics Consortium (BGC), whose members have developed a cheap, high throughput method for measuring the particular DNA letter changes that cause blood group differences.
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By combining GeneTitan with liteTyper (an updated version of bloodTyper) we hope to create a panel of 100,000 donors for whom all blood group types have been determined to facilitate extended blood group antigen matching for patients who require regular transfusions of blood.
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The UK is the first country where patients can access the new genomic blood test, following extensive review from the national regulator, which has deemed the test safe and effective for this use. The authorisation is subject to monitoring via a monthly summary report providing details of any adverse incidents whilst in use. As a similar project in the donor population rolls out, patients who have the test may benefit from better matching blood transfusions in the future, increasing the clinical effectiveness of the transfusion and reducing the risk of side effects.
NHS England (NHSE) has provided initial programme funding for the genomic test to be performed for patients with sickle cell disorder, thalassaemia, and people with transfusion dependent rare inherited anaemias. You can read more about this programme of work here
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More recently work has started on typing the donor population with 77,000 donors undergoing extended typing using this platform.
