Serological and Molecular Compatibility Methods Among Sickle Cell Disease Blood Recipients and Their Donors in a Tertiary Hospital, in North Central Nigeria: a Comparative Study

Abstract

Introduction: Sickle Cell Disease (SCD) is an autosomal recessive genetic blood disorder characterised by abnormal, rigid, sickle cell shape in a hypoxic environment. Most SCD patients require a safe and compatible blood transfusion during crises; hence, there is a need for DNA genotyping blood to avoid haemagglutination in multiple transfused patients. This study compared molecular genotyping to serological compatibility testing methods among sickle cell disease patients attending General Hospital, Ilorin.

Methodology: Fifty sickle cell disease recipients and fifty blood donors in general hospital Ilorin were randomly selected. 5mls of blood sample was collected from each group. Serological compatibility testing was performed on each sample by standard tube agglutination methods. Molecular compatibility testing was done by extracting the genomic DNA followed by polymerase chain reaction techniques. The products were separated by Gel electrophoresis, results were interpreted and analysed.

Results:  The Mean age of the Sickle cell disease recipients is 7.6 (± 4.3) years. Their Mean Body weight is 23.6 (± 8.2) Kg.  About 30 (60%) of the SCD patients have been transfused at least twice before with 50 (16%) history of blood transfusion reaction. Most of the recipients (52%) are of O Rh D positive blood group while the donors are (56%). All the recipients had a negative Indirect Antiglobulin Testing, with 100% compatible for serological and 80% for Molecular procedures. There are (n=10) discrepancies between serological phenotyping and molecular RHCDE genotyping. Which (n=4) were due to Rh D antigens, (n=4) were also due to RhCE antigens and (n=2) were due to both RhCDE antigens. However, there was complete compatibility between serological and molecular compatibility of (n=40) sickle cell disease.

Conclusion: Molecular compatibility testing offers superior sensitivity, specificity, and accuracy when compared to serological compatibility testing methods and should be considered the gold standard when transfusing sickle cell disease patients.