Array genotyping of transfusion-relevant blood cell antigens in 6946 ancestrally diverse study participants

N Nicholas S. Gleadall (1Department of Haematology, Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, United Kingdom) L Lianne Koets (3National Screening Laboratory of Sanquin, Sanquin Blood Supply Foundation, Sanquin, Amsterdam, The Netherlands) O Olga Shamardina (10Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom) J Jeremy Gollub (5Microarray Solutions, Thermo Fisher Scientific, Santa Clara, CA) A Aaron J. Gottschalk (6National Center for Blood Group Genomics, New York Blood Center Enterprises, Kansas City, MO) O Orod Razeghi (1Department of Haematology, Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, United Kingdom) G Gorka Ochoa-Garay (7Laboratory of Blood Group Genomics, New York Blood Center Enterprises, New York, NY) J Jonathan Stephens (1Department of Haematology, Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, United Kingdom) R Ram Varma (5Microarray Solutions, Thermo Fisher Scientific, Santa Clara, CA) J Jennifer Martin (1Department of Haematology, Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, United Kingdom) E Elias Allara (1Department of Haematology, Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, United Kingdom) C Colin J. Brown (11Histocompatibility and Immunogenetics, National Health Service Blood and Transplant, London, United Kingdom) J James Daly E Emanuele Di Angelantonio S Shane Grimsley (15International Blood Group Reference Laboratory, National Health Service Blood and Transplant, Bristol, United Kingdom) W W. Martin Howell (16Histocompatibility and Immunogenetics, National Health Service Blood and Transplant, Newcastle, United Kingdom) K Kati Hyvärinen U Ute Jentsch (18South African National Blood Service, Johannesburg, South Africa) N Nathalie Kingston C Celina Montemayor (20Red Cell Genomics, Canadian Blood Services, Toronto, Canada) C Celeste Moya-Valera (1Department of Haematology, Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, United Kingdom) J John Ord (1Department of Haematology, Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, United Kingdom) J Jukka Partanen D David Roberts K Kathleen E. Stirrups S Sunitha Vege (7Laboratory of Blood Group Genomics, New York Blood Center Enterprises, New York, NY) L Lindsay Walker (1Department of Haematology, Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, United Kingdom) A Andrea Harmer (1Department of Haematology, Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, United Kingdom) S Shantanu Kaushikkar (5Microarray Solutions, Thermo Fisher Scientific, Santa Clara, CA) W Willem H. Ouwehand (1Department of Haematology, Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, United Kingdom) C C. Ellen Van der Schoot (6Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands, Amsterdam, Netherlands) C Connie M. Westhoff B Barbera Veldhuisen (4Department of Experimental Immunohematology, Sanquin Blood Supply Foundation and Landsteiner Laboratory, Amsterdam University Medical Center, Amsterdam, The Netherlands) W William J. Lane (29Department of Pathology, Brigham and Women’s Hospital, Boston, MA)

Abstract

Abstract Blood transfusions save millions of lives worldwide each year, yet formation of antibodies against nonself antigens remains a significant problem, particularly in patients who receive frequent transfusions. We designed and tested the Universal Blood Donor Typing (UBDT_PC1) array for automated high-throughput simultaneous typing of human erythrocyte antigens (HEAs), platelet antigens (HPAs), leukocyte antigens (HLAs), and neutrophil antigens to support selection of blood products matched beyond ABO/Rh. Typing samples from 6946 study participants of European, African, Admixed American, South Asian, and East Asian ancestry at 2 different laboratories showed a genotype reproducibility of ≥99% for 17 244 variants, translating to 99.98%, 99.90%, and 99.93% concordance across 338 372 HEA, 53 270 HPA, and 107 094 HLA genotypes, respectively. Compared with previous clinical typing data, concordance was 99.9% and 99.6% for 245 874 HEA and 3726 HPA comparisons, respectively. HLA types were 99.1% concordant with clinical typing across 8130 comparisons, with imputation accuracy higher in Europeans vs non-Europeans. Seven variant RHD alleles, a GYPB deletion underlying the U− phenotype, and 14 high-frequency antigen-negative types were also detected. Beyond blood typing, hereditary hemochromatosis-associated HFE variants were identified in 276 participants. We found that the UBDT_PC1 array can reliably type a wide range of blood cell antigens across diverse ancestries. Reproducibility and accuracy were retained when transfusion-relevant targets from the UBDT_PC1 array were incorporated into the UKBB_v2.2 genome-wide typing array. The results represent the potential for significant advancement toward improved patient care by reducing harm in transfusion recipients through extended matching.

Article Details

Journal Blood
Volume / Issue Vol. 146, Issue 12
Published September 18, 2025
Pages 1511-1524
ISSN 0006-4971
Publisher Elsevier BV

Journal Info

Blood

Elsevier BV

ISSN: 0006-4971 Health Sciences

Authors (34)

N

Nicholas S. Gleadall

1Department of Haematology, Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, United Kingdom

L

Lianne Koets

3National Screening Laboratory of Sanquin, Sanquin Blood Supply Foundation, Sanquin, Amsterdam, The Netherlands

O

Olga Shamardina

10Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom

J

Jeremy Gollub

5Microarray Solutions, Thermo Fisher Scientific, Santa Clara, CA

A

Aaron J. Gottschalk

6National Center for Blood Group Genomics, New York Blood Center Enterprises, Kansas City, MO

O

Orod Razeghi

1Department of Haematology, Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, United Kingdom

G

Gorka Ochoa-Garay

7Laboratory of Blood Group Genomics, New York Blood Center Enterprises, New York, NY

J

Jonathan Stephens

1Department of Haematology, Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, United Kingdom

R

Ram Varma

5Microarray Solutions, Thermo Fisher Scientific, Santa Clara, CA

J

Jennifer Martin

1Department of Haematology, Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, United Kingdom

E

Elias Allara

1Department of Haematology, Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, United Kingdom

C

Colin J. Brown

11Histocompatibility and Immunogenetics, National Health Service Blood and Transplant, London, United Kingdom

J

James Daly

E

Emanuele Di Angelantonio

S

Shane Grimsley

15International Blood Group Reference Laboratory, National Health Service Blood and Transplant, Bristol, United Kingdom

W

W. Martin Howell

16Histocompatibility and Immunogenetics, National Health Service Blood and Transplant, Newcastle, United Kingdom

K

Kati Hyvärinen

U

Ute Jentsch

18South African National Blood Service, Johannesburg, South Africa

N

Nathalie Kingston

C

Celina Montemayor

20Red Cell Genomics, Canadian Blood Services, Toronto, Canada

C

Celeste Moya-Valera

1Department of Haematology, Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, United Kingdom

J

John Ord

1Department of Haematology, Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, United Kingdom

J

Jukka Partanen

D

David Roberts

K

Kathleen E. Stirrups

S

Sunitha Vege

7Laboratory of Blood Group Genomics, New York Blood Center Enterprises, New York, NY

L

Lindsay Walker

1Department of Haematology, Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, United Kingdom

A

Andrea Harmer

1Department of Haematology, Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, United Kingdom

S

Shantanu Kaushikkar

5Microarray Solutions, Thermo Fisher Scientific, Santa Clara, CA

W

Willem H. Ouwehand

1Department of Haematology, Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, United Kingdom

C

C. Ellen Van der Schoot

6Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands, Amsterdam, Netherlands

C

Connie M. Westhoff

B

Barbera Veldhuisen

4Department of Experimental Immunohematology, Sanquin Blood Supply Foundation and Landsteiner Laboratory, Amsterdam University Medical Center, Amsterdam, The Netherlands

W

William J. Lane

29Department of Pathology, Brigham and Women’s Hospital, Boston, MA