In a landmark development for personalised medicine, 77,000 donors have had their blood types DNA tested (genotyped). This is the first step towards enabling the NHS to precision-match blood from donor to recipient during transfusions. This work was conducted by NHS Blood and Transplant and was part of the STRIDES study, which is led by the National Institute for Health and Care Research (NIHR) BioResource. This marks the first time blood groups have been DNA tested on such a scale in the UK and paves the way for improving donor-recipient matching and reducing the risk of side effects and reactions from blood transfusions.
The genotyping, carried out by NHSBT’s Molecular Diagnostics team, has already identified dozens of donors with rare blood types; a number expected to rise into the hundreds as analysis continues. These rare blood units can be frozen and stored for future use, either for recipients with matching needs or for the donors themselves.
With 362 known blood types, precisely matching the blood types of donors and recipients is complex. People can develop severe reactions against blood types that their body doesn’t recognise. Precision-matching helps prevent this by ensuring the donor’s blood is closely aligned with the recipient's. This is especially critical for patients who require frequent transfusions, such as those with sickle cell disorder or transfusion-dependent thalassaemia.
Dr Nathalie Kingston, Director of the NIHR BioResource, praised the volunteers:
"Volunteers in the NIHR STRIDES BioResource are already making a significant contribution to research and we are proud to support this work through our partnership with NHSBT.
"There is huge potential to improve blood matching, particularly important for those with inherited anaemias like sickle cell disorder and thalassaemia, or those with rare blood groups, through this work.
This complements our Improving Black Health Outcomes (IBHO) BioResource which initially focuses on those living with sickle cell disorder, many of whom require regular blood transfusions.”
Dr Gail Miflin, Chief Medical Officer at NHS Blood and Transplant said:
“At NHS Blood and Transplant, we are always working to improve patient experience and health outcomes, through an extensive programme of research and development, including the STRIDES study.
"Taking these 77,000 donors and testing their blood to such a precise level has been an incredible undertaking and will work to significantly change the way we issue blood – especially to those patients at higher risk of transfusion related reactions.
“We will be able to match to an increasing number of blood groups, ensuring that patients have blood that is most similar to their own and reducing the risk of any reactions. It is an example of just how we are driving innovation which can radically improve patient outcomes.”
Kate Downes, Genomics Programme Director at NHS Blood and Transplant, said
“Having the ability to genotype 77,000 donors as a part of the NIHR STRIDES BioResource study is extremely significant – this inventory of blood will enhance our capacity to find units with rare blood groups for difficult to match patients as well as provide better matched units for patients who have an increased risk of transfusion reactions, aiding us in our mission to save and improve even more lives.
"As an organisation, NHSBT is focused on investing in research and development and driving innovations that could radically improve patient outcomes and our partnership with the NIHR BioResource is a strong example of that.
"This genotyping is a first major step towards rolling out precision matched blood more widely, which would be a landmark change in how blood is matched.”
Ryan Wilkinson, 33, a Civil Servant from Essex, discovered he has a rare Lu(a+b-) blood type as a part of the study – a subtype only 0.2% of the population has. He said:
“It was amazing to find out that I had such a rare blood type. When I initially signed up to the STRIDES study, I didn’t think that anything would come of it, but it seems so, so worth it now.
"I was so surprised when I got the letter explaining the results of my blood testing and have now joined an international register of people with rare blood types like mine.
"It’s so valuable to know that my blood could now be used in a more targeted way and have a greater impact on somebody’s life when they need it most."
Dave Sale, 66, a retired serviceman from Market Drayton, Shropshire, has been a blood donor since the age of 18 and has recently discovered he has a rare Co(a-) blood subtype, found in up to 0.5% of the population. He said:
“I was very surprised to discover that I have such a rare blood type and find it quite incredible that there are so few who have it, it’s extraordinary!
It is very reassuring to know that NHS Blood and Transplant are carrying out this type of work, so that my blood may be able to help somebody else directly – or perhaps even myself, if I were ever so unfortunate.”
Jamie Mullen, 30, from London, discovered he has a rare Yt(a-) blood subtype – found in 0.3% of the population - after he agreed to be a part of the STRIDES study at a regular blood donation appointment. He said:
I’ve always donated blood because I wanted to help other people. Finding out that I’ve got a rare blood type has given me even more reason to find the time to donate blood, knowing that could be integral in somebody’s care.
"It’s interesting to learn about the progress being made in matching blood to individuals even more closely and I look forward to seeing how this could impact future patient care.”
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