[PPT] - Rare donor program in Japan Yoshihiko Tani, MD, PhD Japanese Red PowerPoint Presentation

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Japanese Red Cross Kinki Block Blood Center

Rare donor program in Japan

Yoshihiko Tani, MD, PhD

Japanese Red Cross Kinki Block Blood Center

ISBT Working Party on Rare Donors

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Japanese Red Cross Kinki Block Blood Center

Have a national Rare Donor Program

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Japanese Red Cross Kinki Block Blood Center

Rare Blood in Japan

Category I (35) Category II (5)

Bombay para- Bombay Mk/M /Mk En(a–) MiV/MiV Nsat/N /Nsat S–/s /s–/U /U– p Pk Rhnull Rhmod –D– cD cD– LW(a–b–) Lu(a–b–) In(Lu) Ko Kp(a+ b–) Kp(a–b–) K14 – k– Kmod McLeod Fy(a–b–) Jk(a–b–) I – Ge:–2, 2,–3 Lan– IFC– UMC– Dr(a–) Gy(a–) Ok(a–) JMH– Er(a–) s– Fy(a–b+ ) Di(a+ b–) Jr(a–) Do(a+ b–)

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Japanese Red Cross Kinki Block Blood Center

Number of Donors in Database

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Japanese Red Cross Kinki Block Blood Center

Registration of Rare Donors in Japan

(Category I)

Rare Blood RhD + RhD – Bombay 5 MkMk 1 En(a–) 2 MiV / MiV 4 Nsat/Nsat 1 S–s–U– 2 1 Pk 2 Rhnull － 5 Rhmod － 7 Kp(a–b–) 2 k– 8 K:–14 2 Fy(a–b–) 6 as of 2012.3.31 Rare Blood RhD + RhD – McLeod 19 I – 19 Ge– 11 Lan– 16 Gy(a–) 6 Ok(a–) 19 JMH– 12 para- Bombay 77 p 25 1 D– – 103 － In(Lu) 93 1 Ko 100 2 Jk(a–b–) 69 1

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Japanese Red Cross Kinki Block Blood Center

Registration of Rare Donors in Japan

（Category Ⅱ）

Rare Blood

RhD + RhD – Fy(a–) 3,117 495 Di(b–) 2,671 101 Jr(a–) 2,130 42 s– 342 106 Category I

as of 2012.3.31

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Japanese Red Cross Kinki Block Blood Center

Number of Rare Blood Donors registered

(Category I) (1996 - 2011)

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Japanese Red Cross Kinki Block Blood Center

Number of Rare Blood Donors registered

(Category I) (1996 - 2011)

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Japanese Red Cross Kinki Block Blood Center

Number of Rare Blood Donors registered

(Category II) (2000 - 2011)

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Japanese Red Cross Kinki Block Blood Center

Number of Frozen Rare Cells

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Number of Frozen Rare Cells

Rare Blood

A O B AB

+ – + – + – + –

Bombay 18 para-Bombay 79 60 16 4 Rhnull 13 Rhmod 9 D– – 89 25 23 20 p 1 3 6 4 Pk 3 En(a–) 8 15 MiV/MiV 7 Ko 50 55 2 51 1 32 McLeod 18 14 32 4 Jk(a–b–) 53 64 4 26 29 I– 15 10 5 10 Ge– 24 11 13 Lan– 19 20 8 3 Gy(a–), Hy– 6 1 Ok(a–) 17 9 6 18 Fy(a–b–) 14 11 3 1 1 1 In(Lu) 37 4 35 33 7 31 numbers

as of 2012.3.31

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Japanese Red Cross Kinki Block Blood Center

How are Rare Donors found?

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Japanese Red Cross Kinki Block Blood Center

Monoclonal antibodies for blood grouping (1)

Cell line MoAb Cell line MoAb Cell line MoAb OSK1 anti-CD44 OSK7 anti-Pk OSK15-1 anti-P OSK1-1 OSK8 anti-U＋N OSK15-2 OSK2 anti-Rh29 (anti-Rh17) OSK9 anti-A OSK16 anti-H OSK2-1 OSK9-1 OSK16-1 OSK2-2 OSK10 anti-B OSK17 anti-P1 OSK3 anti-D OSK10-1 OSK17-1 OSK3-1 OSK10-2 OSK17-2 OSK3-2 OSK11 anti-M OSK17-3 OSK3-3 OSK12 anti-N OSK18 anti-Le related OSK3-4 OSK12-1 OSK18-1 anti-LebH OSK4 anti-EnaFR OSK13 anti-Lea OSK19 anti-Fy6 OSK4-1 anti-EnaFS OSK13-1 OSK20 anti-E OSK4-2 anti-EnaTS OSK13-2 OSK20-1 OSK5 anti-K2 OSK14 anti-I OSK20-2 OSK6 anti-Ge OSK15 anti-P OSK21 anti-Acquired B

red：Human MAb ：rare blood screening

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Japanese Red Cross Kinki Block Blood Center

Monoclonal antibodies for blood grouping (2)

Cell line MoAb Cell line MoAb Cell line MoAb OSK22 anti-Fy3 OSK29-2 anti- GPA&B OSK36 anti-Kpb OSK22-1 OSK29-3 OSK37 anti-Dia OSK22-2 OSK29-4 OSK38 anti-Xga OSK23 anti-T OSK29-5 OSK39 anti-IFC OSK24 anti-Tn OSK29-6 OSK40 anti-Miltenberger OSK24-1 OSK29-7 OSK41 anti-Fyb OSK25 anti-K14 OSK29-8 anti-GPA OSK42 anti-e OSK25-1 OSK30 anti-Jra OSK43 anti-Lan OSK26 anti-c OSK31 anti-Dib OSK44 anti-Hro OSK27 anti-Tk OSK32 anti-K5 (Ku) OSK46 anti-Kg OSK28 anti-i OSK33 anti-Kpc OSK47 anti-Fya OSK29 anti-GPA&B OSK34 anti-K1 OSK48 anti-C OSK29-1 OSK35 anti-Jkb OSK49 anti-S

OSK-MoAb: 49 kinds, 93 cell lines red：Human MAb ：rare blood screening

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Japanese Red Cross Kinki Block Blood Center

Blood Grouping Reagent : Cross-linked Monoclonal antibody

Mouse anti-human IgG MoAb

mix

Human MoAb Red Blood cells Cross-linked MoAb agglutination

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Japanese Red Cross Kinki Block Blood Center

Total volume of monoclonal antibodies supplied to

ther blood centers（1987-2009）

Year

No. of

MoAbs

No. of Blood

centers supplied Total volume (mL) 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 6 8 14 15 20 24 24 27 28 30 26 31 27 36 31 34 32 30 37 34 33 35 28 32 39 19 23 19 21 23 23 22 30 45 41 31 36 25 28 32 34 34 37 34 28 19 12 10 10 10 21,890 18,290 15,540 16,840 19,845 20,460 18,045 30,348 50,301 59,018 49,187 32,217 28,655 39,731 56,962 75,770 77,005 87,590 111,910 97,630 125,050 255,365 330,512 397,204 455,610

1987~： anti-Ena, anti-Hro(Rh17) anti-K2, anti-Ge anti-U+N, anti-CD44 1991~： anti- I 1994~： anti-Jra, anti-Dib 2005~： anti-Lan 2007~: Consolidating of laboratory ・Screening of rare blood ・Screening of antigen negative blood ・Blood typing

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Japanese Red Cross OSAKA Blood Center

Automated machine

PK7300

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Japanese Red Cross Kinki Block Blood Center

Images of hemagglutination on PK7300

D ABO antibody rare blood 1 2 3 4 5 6 7 8 9 10

A D − Ab− A D＋ Ab− A D＋ Ab− O D＋ Ab− O D＋ Ab− O D＋ Ab− B D＋ Ab− B D＋ Ab− AB D＋ Ab− AB D＋ Ab−

detamination

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Japanese Red Cross Kinki Block Blood Center

Number of Rare Donor units used per year

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Japanese Red Cross Kinki Block Blood Center

Units of Rare Blood Provided (Category I)

(1997 – 2011)

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Japanese Red Cross Kinki Block Blood Center

Units of Rare Blood Provided (Category I) (2000 – 2011)

units 10 20 30 40 50 60 D– – Jk(a–b–) p Ko Bombay (para)

2011

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Japanese Red Cross Kinki Block Blood Center

Units of Rare Blood Provided (Category II) (2000 - 2011)

200 400 600 800 1.000 Jr(a–) Fy(a–) Di(b–)

Units

2011

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Japanese Red Cross Kinki Block Blood Center

Units of Rare Blood Internationally shipped (1977–1998)

year country rare blood units

1977

Germany(W)

Di(b–) 6 1981

Germany(W)

Di(b–) 16 1982

USA Germany(W)

D– – Di(b–) 19 9 1983

Germany(W) Germany(W) France

Di(b–), Ccee, Fy(b-)

Di(b–), Jk(b-) D– – 6 13 12 1984

Thailand Germany(W)

Bombay(Para-Bombay)

Di(b–), Jk(b-) 5 16 1985

Thailand Germany(W)

p Di(b–), Jk(b-) 4 10 1986

Germany(W)

Di(b–), Jk(b-) Di(b–) Ko 20 9 6 1987

Germany(W)

Ko 6

year country rare blood units

1988

USA Germany(W) Thailand

MkMk Ko Bombay 6 8 4 1989

USA Germany(W) Thailand

Jr(a–) Ko Di(b–) 4 4 14 1991

Thailand

Bombay 7 1995

Australia Thailand

Di(b–) Ko 8 9 1996

Sweden

Di(b–) 8 1997

Taiwan USA

Jk(a–b–) D– – 11 6 1998

Switzerland Norway Argentina UK

Ko Jr(a–) D– – Jr(a–) 8 8 4 4

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Japanese Red Cross Kinki Block Blood Center

Units of Rare Blood Internationally shipped (1999–2012.3)

year country rare blood units

1999

Sweden USA Netherlands

En(a–) Jr(a–) Ko 12 4 10 2000

Indonesia UK

Para-Bombay

D– – 10 6 2001

China Canada

Di(b–) D– – 32 2 2002

Philippine

Jk(a–b–) 2 2003

Spain

D– – 8 2004

Philippine USA Korea Brazil Brazil

Jk(a—b–) Jr(a–) D– – D– – Ko, D– 12 40 8 6 4 2005

Thailand

Czech Republic

Philippine

p D– – Jk(a–b–) 10 8 15

year country rare blood units

2006

Thailand China

Ko Fy(a–), C– 8 16 2007 New Zealand D– – 6 2008

Netherlands Thailand

Di(b–), D–

Fy(a-),C-,e-,Jk(b-)

4 12 2009

Netherlands Thailand Malaysia

Di(b–), D– Fy(a-),C-,e-,Jk(b-) p, Fy(b–) 4 12 2 2010

UK Australia

D– – p 4 4 2011

Canada UK New Zealand

Ko D– – D– – 11 8 4 2012

Australia

Lan– 4

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Japanese Red Cross Kinki Block Blood Center

Units of Rare Blood Internationally shipped–1 (1977–2012.3)

country year rare blood units Germany (West)

1977 1981 1982 1983 1984 1985 1986 1987 1988 1989 Di(b–) Di(b–) Di(b–)

Di(b–), Fy(b-),Ccee

Di(b–), Jk(b-) Di(b–), Jk(b-) Di(b–), Jk(b-) Di(b–), Jk(b-) Di(b–) Ko Ko Ko Ko 6 16 9 6 13 16 10 20 9 6 6 8 4

France

1983 D– – 12

Norway

1998 Jr(a–) 8

Sweden

1996 1999 Di(b–), C–, S–, P2 En(a–) 8 12

country year rare blood units

Netherlands 1999 2009 Ko Di(b–), D– 10 4

Switzerland

1998 Ko, c–E–,Fy(b-) 6

UK

1998 2000 2010 2011 Jr(a–) D– – D– – D– – 4 6 4 8

Spain

2003 D– – 8

Czech Republic

2005 D– – 8

USA

1982 1988 2004 2005 D– – MkMk Jr(a–) Jr(a–) Jr(a–) 19 6 4 40 16

Canada

2001 2011

D– –, Fy(b–), Jk(a–) Ko

2 11

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Japanese Red Cross Kinki Block Blood Center

Units of Rare Blood Internationally shipped–2 (1977–2012.3)

country year rare blood units Taiwan

1997 Jk(a–b–) 11

Hong kong

1997 Di(b–) 8

China

2001 2006 Di(b–), Jk(a–) Fy(a–), C– 32 16

Korea

2004 D– – 8

Australia

1995 2010 2012 Di(b–) p Lan– 8 4 4 New Zealand 2007 2011 D– – D– – 6 4

Argentina

1998 D– – 4

Brazil

2004 Ko, D– D– – 4 6

country year rare blood units Thailand

1984 1985 1988 1989 1991 1995 2005 2006 2009

Bombay(Para-Bombay)

p Bombay Di(b–) Bombay Ko Jk(a–b–) p p Ko, Le(a–) Fy(a–), C–e–, Jk(b–) 5 4 4 14 7 9 9 4 6 8 12

Philippine

2004 2005 Jk(a–b–), c–E– Jk(a–b–) 12 15

Indonesia

2000 Para-Bombay 10

Malaysia

2009 p, Fy(b–) 4

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Japanese Red Cross Kinki Block Blood Center

Countries & Rare Blood Internationally shipped (1977-2012.3)

Germany, Sweden, Norway, France, Netherlands, UK, Switzerland, Spain, Czech Republic, USA, Canada, Argentina, Brazil, Thailand, Philippine, China, Taiwan, Hong Kong, Korea, Indonesia, Malaysia, Australia, New Zealand

23 countries

rare blood units numbers rare blood units numbers Di(b–) 179 25 Bombay (para-) 26 7 D– – 95 17 p 22 5 Jr(a-) 72 6 En(a–) 12 1 Ko 72 15 MkMk 6 3 Jk(a–b–) 47 10 Lan– 4 2 Fy(a–) 28 4 Total 563 92

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Japanese Red Cross OSAKA Blood Center

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Japanese Red Cross Kinki Block Blood Center

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Japanese Red Cross OSAKA Blood Center

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Japanese Red Cross Kinki Block Blood Center

Screening for rare blood by monoclonal antibodies

(1987 ~ 2011)

Monoclonal Antibody

No. of tested

Rare Blood

No. of detected Frequemcy

anti-U+N 2,062,873 U– 3 0.00015 % anti-Ena 12,842.271 En(a–) 2 0.00002 % MkMk 2 0.00002 % anti-Hro 25,703,046 D– – 217 0.00084 % Rhnull 10 0.00004 % anti-CD44 6,850,028 Lu(a–b–) 622 0.00908 % anti-K2, anti-K5, anti-K14 17,265,220 Ko 306 0.00177 % McLeod or Kmod 186 0.00108 % anti-Ge 7,828,135 Ge– 20 0.00026 % anti-Lan 7,197,279 Lan– 69 0.00096 % anti-Fy3 795,239 Fy(a–b–) 0 % anti-IFC 610,271 IFC– 1 0.00016 % anti-I 1,138,211 I– 0 % anti-Jra 21,161,014 Jr(a–) 11,026 0.05211 % anti-Dib 2,532,761 Di(a+b–) 4,763 0.18806 % Including repeat donors

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Japanese Red Cross Kinki Block Blood Center

Frequency of Rare Blood (Japan)

1/100 1/1,000 1/10,000 1/100,000 1/1,000,000

Fy(a–) Di(b–), s– Jr(a–) Lu(a–b–), InLu Ko, Lan– Jk(a–b–), Ok(a–) Ge– –D– Rhnull I– Oh P Fy(a–b–) En(a–) EnaFR– (MiV/MiV, NSAT/NSAT) IFC– Dr(a–) Gy(a–), Kx–(McLeod)

Summarized by Dr. Uchikawa in Tokyo BC

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Japanese Red Cross Kinki Block Blood Center

Other items of interest

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Japanese Red Cross Kinki Block Blood Center

Rare Blood Internationally Provided to Japan

rare blood country units 1974 –D– Canada 4 1977 p USA Canada 2 2 1984 I – USA 2 1985 En(a–) UK 2 1999 Ge – Sweden USA 4 4

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Thank you for your attention.

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