Homologous blood transfusion and doping: Where are we now?

Area of Science:

• Sports Science
• Analytical Chemistry
• Immunology

Background:

• Homologous blood transfusion (HBT) has been a doping method in endurance sports since the 1960s.
• Despite being prohibited by the IOC in 1985, effective detection methods were unavailable until 2003.
• Red blood cell (RBC) minor blood group antigens were identified as unique identifiers for detecting HBT.

Purpose of the Study:

• To describe the development and application of a flow cytometry method for detecting HBT.
• To evaluate the effectiveness and evolution of HBT detection techniques over time.

Main Methods:

• Flow cytometry analysis of isolated RBCs incubated with antibodies against minor blood group antigens.
• Detection of a second RBC population indicated by dual peaks in fluorescence histograms.
• Evaluation of alternative methods including the Athlete Biological Passport and forensic DNA analysis.

Main Results:

• The flow cytometry method successfully identified HBT cases after its implementation in 2004.
• Detection sensitivity was sufficient for a few weeks post-transfusion.
• While forensic DNA analysis offers high specificity, its in vivo sensitivity has been questioned.

Conclusions:

• Flow cytometry remains the primary method for detecting homologous blood transfusion (HBT).
• Ongoing research aims to enhance the specificity and sensitivity of the flow cytometry technique.
• Simplified methods are being developed for more efficient HBT detection.