Phenotyping of minor blood groups (C, c, E, e, and Mia) using a paper-based device and image-based high-throughput detection

Abstract

Testing ABO and D (Rh) are priorities before blood transfusion, and the minor blood group antigen should be matched to reduce alloimmunization. In a recent study, a paper-based device (PAD) was developed for C, E, c, e, Mi^a phenotyping, combined with image-based high-throughput detection. A total of 148 ethylenediamine tetra acetic acid (EDTA) blood samples were used to evaluate and create an optimal criterion using OpenCV for high-throughput interpretation. Results revealed that anti-C, -c, -E, -e, and -Mi^a were successful for blood group phenotyping with area under the receiver operating characteristics curve (AUC) of 1.000 (95% confidence interval [CI], 0.976-1.000), 0.984 (95% CI, 0.984-0.997), 0.997 (95% CI, 0.970-1.000), 0.994 (95% CI, 0.965-1.000), and 1.000 (95% CI, 0.976-1.000), respectively. The validation of these systems for blind blood samples (n = 56) showed 100% sensitivity, specificity, and accuracy compared with the gel card method. PAD with image-based interpretation can be used as an alternative to minor blood group phenotyping without the need for electric power equipment and well-trained personnel. Moreover, this proposed method would help build phenotype databases of blood donors or patients for the preparation of panel cells, find antigen-negative compatible blood for patients with multiple alloantibodies, and prevent alloimmunization in multitransfused patients.

Keywords: Blood group typing; Minor blood group; Paper-based device.