In-Depth Study of ABO, Rhesus, Kell, Duffy, MNS, and Kidd Red Cell Phenotypes in a Cohort of Sickle Cell Patients in Lubumbashi, Democratic Republic of the Congo

Abstract

Introduction

In the Democratic Republic of Congo (DRC), transfusion management for patients with sickle cell disease (SCD) is traditionally limited to ABO and RH1 (D) compatibility screening. This practice exposes multi-transfused pediatric populations to a high hidden risk of red blood cell (RBC) alloimmunization due to unmonitored minor blood group polymorphisms.

Purpose

To establish extended immunohematological mapping of the Rh, Kell, Duffy, Kidd, and MNS systems in a pediatric SCD cohort in Lubumbashi, DRC.

Methods

A cross-sectional study was conducted involving 98 pediatric SCD patients managed across specialized urban medical facilities in Lubumbashi. Extended erythrocyte antigen phenotyping was performed using standard hemagglutination techniques. Statistical analyses were executed using IBM SPSS Statistics (Version 20.0).

Results

The cohort had a mean age of 4.26 ± 3.07 years and a high clinical transfusion burden, with 40.8% of subjects having received three or more transfusions. Complete antigenic invariance (100.0% prevalence) was observed for D, c, e, and s antigens. Conversely, phenotypic variations were identified in antigens C (11.2%) and E (7.1%). The ABO system is dominated by group O (57.14%). The protective Duffy-null phenotype Fy(a−b−) predominated (89.8%), whereas the Kidd system revealed a high proportion of the Jk(b−) variant (66.3%). Bivariate analyses confirmed that the distribution of these blood group variations was statistically independent of sex and geographic origin (p > .05).

Conclusion

Current national transfusion guidelines expose multi-transfused children to significant, unaddressed immunological risk. Implementing extended phenotyping and regional donor-matching registries is necessary to mitigate clinical alloimmunization complications in the DRC.