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The identification of para-Bombay phenotype and its transfusion strategies

YANG Xiaojun;XIE Haihua;PENG Yingxia;CHEN Xing;CHEN Fawen;Department of blood transfusion ,Clinical College of Fujian Provincial Hospital,Fujian Medical University;Fujian Provincial Jinshan Hospital;  
Objective To explore the blood type identification method,the serological characteristic and the blood transfusion strategy of para-Bombay phenotype. Methods ABO blood group typing of the proband and her fourth sister were performed by Gel card techniques and the manual tube test. The presence of weak A or B antigen on the RBCs was confirmed by adsorption-elution tests. Blood group substances in the saliva were detected by saliva agglutination inhibition test. Serum irregular antibodies were screened. The polymerase chain reaction( PCR) was applied to identify the ABO and FUT1 genotype.Exon 6 and Exon 7 of the ABO gene and the entire coding region of FUT1 gene were amplified and sequenced. Blood group serological method was used to screen transfusion-ready suspended red blood cells. Results The proband and her fourth sister were confirmed as para-Bombay phenotype Bmh and Omh respectively by blood group serological method. Anti-H was detected in the serum. The ABO genotype of them were BO2 and O1 O2,respectively. FUT1 genotyping showed all 5 to be h1 h1. The proband's ABO genotype was B101/O02 by DNA sequence analysis. Direct sequencing indicated that the FUT1 sequence of the proband contained a homozygous 547—552 del AG. Conclusion The combination of blood group serology and molecular biology can accurately identify para-Bombay phenotype. Special blood transfusion strategies are required in the blood transfusion of para-Bombay blood group to avoid the adverse reactions.
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