Rh and Kell blood group antigen prevalence in a multi-ethnic cohort in Nigeria: implications for local transfusion...

Antigens belonging to the Rh and Kell blood group systems are of major clinical significance because of their immunogenicity and the potential of their consequent antibodies to cause in vivo destruction of exogenous red blood cells (RBCs). Despite the wide-spread use of transfusion, there are sparse data on the prevalence of Rh and Kell system antigens and their ethnic variability in Nigeria. The objective of this study was to determine the prevalence of the five major Rh (D, C, c, E, e) and Kell (K) system antigens in Nigeria with the goal of understanding alloimmunization risk in transfusion recipients and improving transfusion safety through the availability of resources, such as antisera for extended RBC typing and antigen panels for alloantibody detection. A multi-ethnic cohort of 302 healthy Nigerian individuals was created to study RBC antigen prevalence. The antigen status of these individuals for Rh and K antigens was determined using commercially prepared antisera and conventional tube agglutination methods. The prevalence of the Rh antigens in the study cohort was found to be: D (92.7%), C (20.5%), c (97.7%), E (19.5%), and e (97.4%). Dce was the most common Rh phenotype (53.3%). The prevalence of K was 0 percent. For all antigens, there was no association between ethnicity and antigen prevalence. This study is the first to document the prevalence of the major Rh and K antigens in the Nigerian population, using a multi-ethnic cohort. Serologic testing demonstrates a zero prevalence of K antigen, which has never been described. C and E pose the higher risks of alloimmunization, hence showing a need for extended RBC typing and matching in at-risk blood recipients. This study demonstrates that phenotyping for major Rh and K antigens within the Nigerian population can potentially improve transfusion safety and prevent alloimmunization.