Immunohematology 718.752.4771 Email: immuno@nybloodcenter.org

Genomics 718.752.4637 Email:molecular@nybloodcenter.org

NYBC's Laboratory of Immunohematology and Genomics provides reference laboratory services and consultation to assist hospitals in the resolution of patient antibody problems and to locate suitable units of blood for transfusion. The laboratory maintains one of the largest collections of well-characterized red cells to identify antibodies and one of the largest inventories of liquid and frozen donor units to support patients who need antigen-negative units for transfusion. The laboratory also participates in the American Rare Donor Program (ARDP) to find rare blood that cannot be found locally.

The laboratory, under the direction of Connie Westhoff, PhD(CWesthoff@nybloodcenter.org), receives more than 1,800 requests annually from hospitals and blood centers nationwide for help in identifying antibodies, and over 20 requests daily for assistance in matching donors to patients. The laboratory relies on the skill of a number of experienced and nationally recognized technologists.

Immunohematology testing services include investigation of:

• Antibodies to red cell antigens
• Warm autoantibodies
• Cold autoantibodies
• Transfusion reactions
• Hemolytic disease of the fetus and newborn
• Drug-induced hemolytic anemia
• Polyagglutination

The Genomics Laboratory offers testing of DNA and RNA for blood group antigens and DNA testing for platelet and neutrophil antigens. DNA molecular testing can improve blood typing accuracy, help select compatible donors, aid the management and treatment for neonatal red cell or platelet destruction, and improve transfusion safety and outcomes for patients. The laboratory employs methods that include DNA array, PCR-RFLP, AS-PCR and gene specific amplification and sequencing. Isolation of mRNA and synthesis and sequencing of cDNA is also performed when indicated. The results are interpreted by staff experienced and knowledgeable in genetics and immunohematology.

Genomics testing services include:

• Prediction of red cell phenotype for any system for which the genetic basis is known
• ABO genotyping and investigation of subgroups
• RHD genotyping, including weak D, partial D, and zygosity investigations
• RHCE genotyping, including investigation of partial, altered, or silenced Cc or Ee
• Investigation of null phenotypes and new antigens
• Platelet (HPA) typing, including HPA 1 through 9, 11, and 15
• Neutrophil (HNA) typing (HNA-3a/b)

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Indications for DNA Testing

• Predict RBC phenotype of recently transfused patients or patients with positive direct antiglobulin tests (DAT)
• Obtain extensive antigen profile on:
  • Patients with warm autoantibodies
  • Patients with sickle cell disease or thalassemia
  • Patients who have been transfused and developed an antibody
  • Patients needing long-term transfusion support
  • Patients whose RBCs demonstrate spontaneous agglutination
• Resolution of complex antibody identification and/or distinguish allo from autoantibody
• Resolution of Rh typing discrepancies
• Resolution of ABO discrepancies
• Confirmation of weak or partial D phenotypes in women of child bearing age to guide transfusion and/or RhIG administration
• Identification of antigen-negative donor units if antisera is unavailable or limited in supply
• Typing of panel cells for uncommon or weakly expressed antigens
• Identification of novel antigens or phenotypes
• Testing for platelet antigens and post-transfusion purpura (PTP)

Fetal or Neonatal Testing

• Evaluation of fetal risk for hemolytic disease of the fetus or newborn (HDFN) due to maternal antibodies to red cell antigens
• Evaluation of fetal risk for alloimmune thrombocytopenia (NAIT) due to maternal antibodies to platelet antigens
• Confirmation of maternal type, paternal zygosity, and fetal type