Understanding the red cell antigen genotyping report: New online resources for healthcare professionals

Red cell antigen genotyping

Red cell antigen genotyping is a type of genetic testing offered through Canadian Blood Services at the National Immunohematology Reference Laboratory (NIRL). Available to healthcare providers across the country, this precise and comprehensive testing provides detailed information about specific antigens that may be present in a patient’s blood.

Antigens may cause the immune system to produce antibodies, so understanding a patient’s unique combination of antigens is critical to selecting appropriate transfusion strategies.

Patients who may benefit from red cell antigen genotyping include those with antibodies who have recently received transfusions and those who frequently receive transfusions, such as people living with sickle cell disease. Patients who are going to be receiving monoclonal antibody therapies like anti-CD38 may also require this genotyping test.

In several clinical situations, red cell antigen genotyping is the standard of care for blood typing. As Tammy Ison, regional lab manager at Canadian Blood Services, describes, “Molecular testing results like these are extremely powerful pieces of information for healthcare providers.”

Interpreting the report

Red cell antigen genotyping reports can be complex and should always be interpreted in conjunction with the patient’s clinical context. According to Ison, understanding how the genotyping reports are interpreted ultimately benefits the patient, “The more you understand the information behind how the result is interpreted, the more you can understand the impact to the clinical situation.”

In response to hospital feedback that identified a need for assistance in interpreting red cell antigen genotyping reports, Ison contacted Dr. Celina Montemayor-Garcia, a medical officer at Canadian Blood Services, and the two began brainstorming about how to provide more information to the healthcare providers receiving these reports. From those conversations came the idea to create simple and user-friendly online resources that could be hosted on Canadian Blood Services’ Professional Education website.

“Our intent was to create an educational tool that could be a resource for hospitals of different sizes that have varying levels of internal expertise, allowing the knowledge to be accessible to everyone,” says Ison. “Previously, there hadn’t been a vehicle to get this information out. The creation of this online course is an approach that will help share practical and important information about interpretation of the red cell antigen genotyping reports at the level of those who receive them.”

The new resources

The online resources about interpreting red cell antigen genotyping reports include:

1. The introductory resource, Red cell antigen genotyping report: A quick glance, that provides a brief overview about basic interpretation of one of these reports.
2. An additional, comprehensive course with further details about specific report components.

The introductory resource is now available on Canadian Blood Services’ Professional Education website. Users can view a sample report and click through important notes on each section, building familiarity with the report components and awareness of key considerations for its interpretation. Accompanied by a downloadable PDF summary page, this resource is designed to address common questions about key aspects of report interpretation. The comprehensive course is currently under development for release later in 2022.

The role of NIRL

The National Immunohematology Reference Laboratory (NIRL) is one of the largest of Canadian Blood Services’ labs offering advanced genetic testing and the only lab offering this specific ID CORE XT red cell antigen genotyping assay. For Canadian hospitals, NIRL provides another valuable service beyond just testing: the opportunity to connect with experts through direct consultation.

As Montemayor-Garcia describes, “When it comes to selecting the transfusion strategies for a patient, genotyping is one part of the puzzle. To put the whole picture together and determine transfusion strategies for the patient, communication between the requesting physician and NIRL about the clinical context is so important in providing the best care for patients.”

Montemayor-Garcia hopes that the introductory course will emphasize the support that NIRL can offer to those that receive these red cell antigen genotyping reports. “The new course includes the contact information for NIRL. We wanted to make this prominent because it’s important for course users to realize that we are available to help interpret the report, especially in cases when there are complexities like variant antigens or discrepancies with serologic testing.”

Montemayor-Garcia emphasizes the importance of this connection between NIRL and hospital customers: “Right now, we receive approximately 3 calls a week and in responding to these calls, we build a relationship with the customers accessing our services. Together with healthcare providers, we can work on integrating all the available information that aids in determining the final transfusion strategy.”

Next steps

Healthcare providers including physicians, laboratory technologists, nurse practitioners, and others who may receive these red cell antigen genotyping reports are invited to view the A quick glance course, download its helpful PDF summary page for quick reference during their day-to-day, and share this course with others in their networks.

For access to the red cell antigen genotyping report resources, visit Canadian Blood Services’ professional education website.

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The opinions reflected in this post are those of the author and do not necessarily reflect the opinions of Canadian Blood Services nor do they reflect the views of Health Canada or any other funding agency.