Current blood typing techniques rely on antibody-antigen interactions to cause red blood cell agglutination for positive identification. Traditional techniques, such as gel columns, are well established, but require laboratory equipment that is often too expensive or not readily available in most developing countries. The process is also time consuming. This is especially true when testing the array of secondary blood groups. Currently, there are 33 blood groups recognised, with over 600 blood group antigens documented, many of which are clinically significant and must be identified prior to transfusions to avoid a potentially fatal haemolytic transfusion reaction. A paper based blood typing diagnostic offers a cheaper, faster and more accessible alternative.  Agglutinated blood is unable to travel through the porous structure of paper, indicating a positive antibody-antigen interaction has occurred. Conversely, non-agglutinated blood is able to wick through the paper structure with relative ease to disappear, upon elution with a saline solution, thus indicating a negative result. This principle has been previously demonstrated using the primary blood groups, ABO and RhD. However, secondary blood groups, such as the Rhesus, and Duffy and Kell systems, have not yet been explored.  Current results have indicated the importance of antibody structure for successful agglutination. However, identification of certain blood groups using paper is constrained by the commercial availability of the blood group antibody structure. Immunoglobulin M (IgM) antibodies show strong agglutination, while immunoglobulin G (IgG) antibodies show weak reactions which often result in false negative results. The pentameric structure of IgM has five times more binding sites compared to the singular IgG antibody. The increased binding capabilities of IgM are able to form larger aggregates which are unable to wick through the paper. The challenge has been validating the use of paper as an alternative blood typing diagnostic for secondary blood group typing. This presentation analyses the performance of paper biodiagnostic for the important secondary blood group analysis.

Paper-based diagnostics for secondary group blood typing

247th National Meeting (2014)

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