The NHS is set to introduce a new genetic blood-matching test for thousands living with sickle-cell disease or thalassemia that could reduce painful side-effects of transfusion treatments.
As it marks its 75th year, the NHS is to become the first healthcare system in the world to provide blood group genotyping – a detailed DNA analysis of each patient’s blood group – to more accurately match those in need of transfusions to donated blood.
The landmark new programme, delivered in partnership by NHS England and NHS Blood and Transplant (NHSBT), will help ensure patients receive the best treatment for them, reducing the risk/impact of reactions to donor blood and the development of antibodies that attack the donor blood cells.
Sickle cell disease – which triggers intense pain after red blood cells become sticky, block vessels and restrict oxygen supply – is particularly common in people of Black African and Caribbean heritage. There are around 17,000 people living with the disease in England, with 250 new cases per year. These patients receive more than 10,000 units of blood per month through NHSBT.
People with thalassemia produce either no or too little haemoglobin, which is used by red blood cells to carry oxygen around the body, and this can cause chronic tiredness.
Thalassemia is mainly seen in those with an Asian and Southern Mediterranean heritage, with about 800 patients in England and less than 50 new cases each year. The test will also help patients living with other rare inherited anaemias.
The most common way to treat these conditions is via blood transfusion from donors.
Up to a fifth of patients (17%) can experience bad side-effects after a transfusion because of inadequately matched blood, with the main source of blood for transfusions being people with European ancestry.
These side effects can lead to transfusion reactions and make it difficult to find enough blood for future transfusions. The effects of this can be severe, leading to a patient’s condition deteriorating and in some very rare cases it can lead to death.
A similar programme for donors will eventually result in patients with sickle cell and Thalassemia receiving better-matched blood, reducing the development of antibodies and leading to better care for patients.
Although blood is matched to the ABO and RhD groups – there are many other blood groups for which blood is normally not matched between patient and donor. This can lead to the production of antibodies to attack the donor’s red blood cells.
To tackle this, NHS England is providing funding of almost £1 million to NHSBT to provide blood group genotyping in its specialised molecular diagnostics laboratory. Once a donor database is developed –– this will match all patients with Sickle Cell and Thalassemia needing a blood transfusion more accurately, stop the development of antibodies and lead to better care for patients.
Dr Andrea Harmer. NHS Blood and Transplant’s Genomics Programme Director, said: “An important part of our role is providing donated blood for patients who need transfusions but our work goes much beyond that, providing world class scientific services to make blood transfusions even safer.
“The new genotyping technology being used in this project was developed by an international consortium of which NHSBT is one of the founding members. It received critical support from the NIHR.
“Our scientific work can only help patients if we have blood donors and the demand for ethnically matched blood is on the rise. You can register as a donor at www.blood.co.uk.”