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Amr J Halawani,1 Saif Elden B Abdalla,2 Mahmoud M Habibullah,2 Ghalia Shamlan,3 Neil D Avent4 1Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia; 2Department of Medical Laboratory Technology, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia; 3Department of Food Science and Nutrition, College of Food and Agriculture Sciences, King Saud University, Riyadh, 11362, Saudi Arabia; 4Consultant Molecular Biologist, Bristol, UKCorrespondence: Amr J Halawani, Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia, Email ajjhalawani@uqu.edu.saPurpose: Inherited blood disorders as well as malaria are prevalent in southwestern Saudi Arabia. Patients with specific hemoglobinopathies may require frequent blood transfusions. Accordingly, alloimmunization may occur if donors and recipients are incompatible. Therefore, examination of various blood group antigens to provide compatible blood units is essential. Two alleles of the Diego (DI) blood group system, DI*02.03 and DI*02.04 encode the Wright antigens; Wra and Wrb, respectively. Anti-Wra may lead to alloimmunization during transfusion and pregnancy. Furthermore, the Wrb antigen may involve in interaction between protein receptors for Plasmodium falciparum. This study aimed to investigate the allele/genotype frequencies of the Wright blood groups in southwestern Saudi blood donors regarding the blood transfusion and assessed the population of Jazan Province for susceptibility of Plasmodium falciparum invasion.Materials and Methods: One-hundred-fifty Saudi blood donors were enrolled to this study. DNA was extracted from the blood samples. Primer pairs were designed to capture a single nucleotide variation that distinguishes the Wright alleles. Polymerase chain reaction (PCR) was conducted and followed by standard sequencing.Results: Among the 150 genotyped samples, the only observed allele was DI*02.04 (n = 150, 100%). Accordingly, the genotype prevalence of DI*02.04/DI*02.04 was accounted for (n = 150, 100%).Conclusion: This study demonstrated the allele frequencies of DI*02.03 and DI*02.04 of the DI blood group system in Saudi blood donors. The DI*02.04 allele was the only allele that was observed. Furthermore, the prevalence of the genotypes was determined and the only observed genotype was DI*02.04/DI*02.04. Interestingly, this study indicates that the Saudi Arabian population living in Jazan Province may be more susceptible to Plasmodium falciparum invasion. Moreover, adding the Wright alleles for the transfusion screening panel is not recommended.Keywords: wright blood group, blood group genotyping, blood transfusion, malaria, Saudi Arabia

Amr J Halawani,1 Hisham I Abu-Tawil,2,3 Salah Alharbi,4 Bandar S Almalki,5 Fawaz M Majmi,6 Renad A Miny,1 Nada G Alghoribi,1 Sulaiman S Alabsi,7 Saeed M Kabrah,1 Haneen O Alhaj,8 Musaed M Alshahrani,9 Nora Y Hakami10 1Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia; 2Department of Laboratory and Blood Bank, Prince Mohammed Bin Nasser Hospital, Ministry of Health, Jazan, Saudi Arabia; 3Department of Laboratory and Blood Bank, King Faisal Medical City for Southern Regions, Ministry of Health, Abha, Saudi Arabia; 4Armed Forces Hospital in Jazan, Ministry of Defence, Jazan, Saudi Arabia; 5General Medical Committee, tDirectorate General of Health Affairs, Jazan, Saudi Arabia; 6Department of Pharmacy, Ahad Al Masarihah General Hospital, Ministry of Health, Jazan, Saudi Arabia; 7King Abdulaziz Medical City, Jeddah, Saudi Arabia; 8Kholoud Laboratory for Medical Analysis, Makkah, Saudi Arabia; 9Blood Bank Laboratory, Prince Sultan Military Medical City, Saudi Arabia; 10Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi ArabiaCorrespondence: Amr J Halawani, Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences Umm Al-Qura University, Makkah, Saudi Arabia, Email ajjhalawani@uqu.edu.saPurpose: Jazan Province in Saudi Arabia is notable for its high prevalence of inherited hemoglobinopathies, including sickle cell disease and thalassemia, necessitating frequent blood transfusions for affected individuals. To mitigate risks such as RBC alloimmunization and hemolytic transfusion reactions, ensuring blood compatibility is crucial. The Kell (KEL) blood group system, pivotal alongside the ABO and RH systems, encompasses multiple antigens implicated in these complications. This study aimed to investigate the frequencies of KEL blood group antigens (K, k, Kpa, and Kpb) and determine KEL phenotypes (K/k and Kpa/Kpb) among Saudi blood donors living in Jazan Province.Methods: A total of 138 anonymous healthy Saudi blood donors from Prince Mohammed bin Nasser Hospital in Jazan Province, Saudi Arabia, were enrolled in this study. Anticoagulated blood was analyzed using the gel card technique to assess K, k, Kpa, and Kpb antigens.Results: The prevalence of KEL antigens was as follows: K (n = 9, 6.52%), k (n = 137, 99.28%), Kpa (n = 1, 0.72%), and Kpb (n = 138, 100%). KEL phenotypes observed were K+k+ (n = 8, 5.80%), K+k− (n = 1 0.72%), K−k+ (n = 129, 93.48%), Kp(a+b+) (n = 1, 0.72%), and Kp(a−b+) (n = 137, 99.28%).Conclusion: This study provides insights into the prevalence of KEL blood group antigens and phenotypes in Jazan Province, Saudi Arabia. These findings may contribute to the establishment of a national blood group database and guide transfusion practices to ensure compatibility and minimize alloimmunization risks.Keywords: Kell blood group, blood transfusion, immunohematology, Saudi Arabia

Amr J Halawani,1 Abdullah A Mobarki,2 Ali H Arjan,3 Muhammad Saboor,2 Hassan A Hamali,2 Gasim Dobie,2 Khalaf F Alsharif4 1Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia; 2Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia; 3Department of Laboratory and Blood Bank, King Fahad Central Hospital, Ministry of Health, Jazan, Saudi Arabia; 4Department of Clinical Laboratory Science, College of Applied Medical Sciences, Taif University, Taif, Saudi ArabiaCorrespondence: Amr J Halawani, Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia, Email ajjhalawani@uqu.edu.saPurpose: Sickle cell disease (SCD) and thalassemia are common inherited blood disorders in Saudi Arabia, especially in Jazan Province. Patients with these disorders require multiple blood transfusions, which may lead to alloimmunization because of mismatched blood group antigens. In this study, we examined the alloimmunization and autoimmunization rates in patients with SCD and thalassemia together with the involved antibodies.Patients and Methods: A cross-sectional study was conducted to review the transfusion history records of patients with SCD and thalassemia at Prince Mohammed bin Nasser Hospital, Jazan Province, Saudi Arabia.Results: Four-hundred thirty-eight patients (385 with SCD, 52 with β-thalassemia, and 1 with α-thalassemia) were received leukoreduced red cell transfusions. The alloimmunization and autoimmunization rates in patients with SCD were 12.98% and 0.52%, respectively. In patients with thalassemia, the alloimmunization and autoimmunization rates were 13.21% and 3.77%, respectively. The most prevalent antibodies in the study population were anti-E (17.19%) and anti-K (14.06%).Conclusion: The alloimmunization and autoimmunization rates were determined in patients with SCD and thalassemia in Jazan Province, Saudi Arabia. The results highlight the need for extended phenotyping to include ABO, RH (D, C, c, E, e), K, Fya, Fyb, Jka and Jkb antigens in the screening panel. This will benefit patients to ensure better transfusion practices.Keywords: red cell alloimmunization, sickle cell disease, thalassemia, autoimmunization

Amr J Halawani,1 Mahmoud M Habibullah,2,3 Gasim Dobie,2 Alaa Alhazmi,2,3 Farkad Bantun,4 Mohammed H Nahari,5 Ibrahim Dawmary,6 Hisham I Abu-Tawil6,7 1Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia; 2Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia; 3SMIRES for Consultation in Specialized Medical Laboratories, Jazan University, Jazan, Saudi Arabia; 4Department of Microbiology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia; 5Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Najran University, Najran, Saudi Arabia; 6Department of Laboratory and Blood Bank, Prince Mohammed bin Nasser Hospital, Ministry of Health, Jazan, Saudi Arabia; 7Department of Laboratory and Blood Bank, King Faisal Medical City for Southern Regions, Ministry of Health, Abha, Saudi ArabiaCorrespondence: Amr J Halawani Makkah, 24381 8156, Saudi ArabiaEmail ajjhalawani@uqu.edu.saPurpose: Knowledge of the prevalence of blood group antigens in a given population is important for the prevention of hemolytic reactions. The MNS blood group system (002) has four polymorphic antigens—M, N, S, and s. Anti-S and anti-s antibodies may result in immediate and delayed hemolytic transfusion reactions, and hemolytic disease of the fetus and newborn may occur. The present study investigated the frequencies of the main antigens and phenotypes of the MNS blood group system.Subjects and Methods: We randomly obtained 149 samples from anonymous Saudi blood donors living in Jazan Province. Serotyping was conducted using a gel card to investigate (M, N, S, and s) antigens and phenotypes.Results: The frequencies of MNS antigens were as follows: M = 89.26%, N = 51.67%, S = 61.07%, and s = 82.55%. Regarding the MNS phenotypes, nine phenotypes were observed in the study population. The most common phenotype was M+N–S+s+ (n = 36, 24.16%), in contrast to the least common phenotype M+N–S–s– (n = 1, 0.67%). The prevalence of the MNS phenotypes in the current study population was highly and significantly different from that in Europeans (P = 0.044) and African Americans (P = 0.000).Conclusion: In summary, this study reports the frequencies of the MNS antigens and phenotypes in Jazan Province, Saudi Arabia. The most common phenotype was M+N–S+s+, whereas the least observed phenotype was M+N–S–s–. The outcomes of this study may assist the blood banks in Jazan Province to establish an extended phenotyping protocol including the MNS antigens, in particular S and s antigens, to preclude any alloimmunization events.Keywords: MNS blood group, blood donors, transfusion, Saudi Arabia

Muhammad Saboor,1,2 Amtuz Zehra,3 Hassan A Hamali,1 Amr Jamal Halawani,1 Abdullah A Mobarki,1 Aymen M Madkhali,1 Saleh Abdullah1 1Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia; 2Medical Research Centre (MRC), Jazan University, Jazan, Saudi Arabia; 3Basic Science Department, King Saud Bin Abdulaziz University, Al Ahasa Branch, Saudi ArabiaCorrespondence: Muhammad SaboorDepartment of Medical Laboratory Technology, Faculty of Applied Medical Science, Jazan University, Jazan, Saudi ArabiaTel +966 54 495 9029Email msaboor@jazanu.edu.saPurpose: A2 and A2B are rare phenotypes of the ABO blood group system. Some individuals with A2 and A2B may have anti-A1 antibodies that may be clinically significant or insignificant. The aim of this study was to determine the frequency of A2, A2B phenotypes and anti-A1 antibodies in blood donors in Jazan, Saudi Arabia. This study also evaluated the reactivity potential of anti-A1 antibodies.Materials and Methods: Blood samples collected from 446 blood donors were typed for ABO (cell and serum grouping) and Rh D. Individuals with blood group A and AB were further subtyped by testing with anti-A1 lectin. In addition to the serum grouping using A1 red cells, A2 and A2B individuals were screened for the presence of anti-A1 in their sera against A1 red cells at 4°C, 22°C and 37°C to determine the thermal amplitude of the reacting anti-A1 antibody (if present).Results: Among A and AB, A1 was the commonest phenotype (20.2%, n=90 out of 446) while A1B was found to be 1.8% (n=8) among AB phenotype. A2 and A2B were found to be 2.2% (n=10) and 0.9% (n=4), respectively. Only one individual with A2B blood type showed cold reactive anti-A1 antibody, the strength of which was 32.Conclusion: A2 and A2B were the rarest among ABO phenotypes in the studied population. Although rare, anti-A1 antibody is not so uncommon. Care shall be taken during routine ABO grouping especially in cases of mix-field or weak positive reactions in A and AB phenotypes.Keywords: ABO, anti-A1, subgroups, blood groups, antibodies, Saudi Arabia