Sir,
Blood grouping and cross-matching are important, though routine steps in blood transfusion. There are several blood groups as categorized by the International Society for Blood Transfusion, based upon the presence of antigens on the surface of red blood cells. In addition to routine blood grouping, extended phenotyping of other clinically significant blood groups is imperative in multi-transfused patients. Kell antigen is one of the important clinically significant antigens as it may cause blood transfusion reactions such as Hemolytic transfusion reactions and Hemolytic disease of the newborn.
The present study was conducted on 2000 samples received at the Department of Transfusion Medicine, Government Medical College, Amritsar from eligible blood donors, in order to find the incidence of Kell blood group in the population in and around Amritsar, and it was found to be 3.15 (63 out of 3000) [Figure 1].
Figure 1.
Incidence of Kell blood group in the blood donors in the population
ABO and Rh blood group typing were also done along with Kell antigen and incidence of Kell blood group was found to be similar in various blood groups with no statistical significance, that is, 3.05% in O blood group, 3.49% in A, 3.23% in B, and 2.31% in AB, and 3.19% in Rh positive cases and 2.5% in Rh negative individuals [Figure 2].
Figure 2.
showing frequency of Kell positivity in ABO & Rh blood group
Among the 2000 cases, 1896 were males, out of which 60 (3.17%) were Kell positive, and the remaining 104 were females. Among the 1896 males, 60 were Kell positive, that is, 3.17% and among the 104 females, 3 were Kell positive, that is, 2.89%. The Kell blood group showed no statistical significance in its distribution in relation to sex or religion, with P = 0.8736 and 0.4025, respectively.
The distribution of Kell blood grouping varies markedly in different parts of the world as well as in India. Few studies have been conducted earlier like by Thakral et al.[1] where out of 1240 O blood group donors, 5.56% were K positive. Another study by Singh et al.[2] conducted on 500 voluntary donors found the Kell positive incidence to be 4.4%. A study that was done on Sudanese population[3] concluded the Kell antigen positivity to be 5.6%.
Knowledge of red cell antigen frequencies in a population is helpful in terms of their ethnic distribution, in creating a donor database for preparation of indigenous cell panels, and providing antigen negative compatible blood to patients with multiple alloantibodies. Hemolytic transfusion reactions due to Kell incompatibility are of a significant magnitude and the hemolytic disease in babies born to Kell sensitized mothers can be of serious consequences, and thus, it is suggested that extended blood typing including Kell antigen be implemented for multi-transfused patients. This strategy would be another step forward in improving the safety of blood transfusion.
Acknowledgment
We are thankful to the technologists and staff nurses of Department of Transfusion Medicine.
References
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