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Identification and Blood Transfusion of Rare B(A) Blood Group by Yongqiang Shan, Jinghui Chong, Chunhong Du, Yaohua Xu, Haitao Huang

Background: To study serologic and gene characteristics of the B(A) blood group of one patient in Tianjin, China. To investigate the blood transfusion for patients with B(A) blood group.
Methods: ABO subgroups were identified by standard serologic techniques in ABO typing discrepancy sample from one patient at the Tianjin Medical University General Hospital. DNA (deoxyribonucleic acid) was collected from his sample and PCR (polymerase chain reaction) was used to sequence exons 6 and 7. PCR products were sequenced to identify ABO subgroups and the B(A) allele. Molecular genotyping of the ABO gene was performed by DNA sequencing of exons 6 and 7 of the ABO gene.
Results: The patient’s red cells showed mixed field agglutination reaction (MF) with anti-A and weak reaction (W+) with anti-H. However, it has strong agglutination reaction with anti-B. The patient’s serum showed the presence of anti-A antibody, while it can’t react with B cell. The serological characteristics of the patient's red cells were similar to AxB subtype. Variation sites were confirmed at 261delG, 297 A>G, 526 C>G, 640 A>G, 657 C>T, 703 G>A, 796 C>A, 803 G>C, 930 G>A in exon 6 and 7 of the ABO gene. The sequence was similar to B101 except for nt640 (A>G). Genotyping indicated that the specimen was B(A)04.
Conclusions: Molecular genotyping confirmed the ABO status as B(A)04. The B(A) blood group is associated with a complicated serologic phenotype and DNA detection is necessary for this atypical phenotype sample. To ensure the safety of transfusion, this study developed an emergency transfusion procedure for patients with B(A) type.

DOI: 10.7754/Clin.Lab.2020.201203