Discrepancies between red cell phenotyping and genotyping in daily immunohematology laboratory practice |
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| Affiliation: | 1. University of Washington, School of Medicine, Department of Genome Sciences, Seattle, Washington, USA;2. Bloodworks NW Research Institute, Seattle, Washington, USA;3. Bloodworks NW Specialty Diagnostics, Red Cell Genomics Laboratory, Seattle, Washington, USA;4. Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA;5. Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA;6. Department of Epidemiology, University of Washington, Seattle, Washington, USA;7. Department Physiology and Biophysics, University of Mississippi Medical Center, Jackson, Mississippi, USA;8. Brotman Baty Institute for Precision Medicine, Seattle, Washington, USA;9. Department of Medicine, University of Washington, Seattle, Washington, USA |
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| Abstract: | False-positive and false-negative reactions exist for serological and molecular antigen typing methods. If the predicted phenotype is inconsistent with the patient`s known antibodies or serological phenotype, the discrepancy must be investigated. False-negative and false-positive results are clinically problematic in blood donors and patients. In this study, we investigated discrepant results between serology and molecular testing in patients and blood donors that occurred in daily molecular laboratory practice over a two year-period. SCD patients represented a large percentage of our cases of discrepancies but we also observed a high prevalence of discrepancies between phenotypes and genotypes in blood donors. The main reasons that led to discrepancies were recent transfusions and limitations of phenotyping. Discrepancies classified as false positive phenotype/true negative genotype and false negative phenotype/true positive genotype occurred mainly in patients with recent transfusions and individuals with RH variants while those classified as true negative phenotype/false positive genotype involved null phenotypes due to silent genes. Despite the limitations of molecular methods currently employed, we found more false-negative and false-positive phenotypes than genotypes demonstrating that genotyping is more efficient to define the blood types, especially in transfusion dependent patients. |
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| Keywords: | Phenotype Genotype Hemagglutination Molecular methods |
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