Trends of ABO and Rh phenotypes in transfusion-dependent patients in Pakistan


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American National Red Cross

Subject: Medical Laboratory Technology


ISSN: 0894-203X
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VOLUME 32 , ISSUE 4 (December 2016) > List of articles

Trends of ABO and Rh phenotypes in transfusion-dependent patients in Pakistan

Nida Anwar / Munira Borhany * / Saqib Ansari / Sana Khurram / Uzma Zaidi / Imran Naseer / Muhammad Nadeem / Tahir Shamsi

Keywords : ABO, Rh phenotype, alloimmunization

Citation Information : Immunohematology. Volume 32, Issue 4, Pages 170-173, DOI:

License : (Transfer of Copyright)

Published Online: 09-October-2019



The objective of this study was to determine the prevalence of ABO and Rh phenotypes in the general Pakistan population. This information could be used to help reduce the rate of alloimmunization in patients with blood disorders, such as thalassemia major, who require frequent blood transfusions. A total of 242 patients with blood disorders requiring frequent blood transfusions were enrolled in the study. ABO and Rh typing was performed on samples from these patients using tube and gel methods. Of these 242 patients, 146 (60.4%) were male and 96 (39.6%) were female. The prevalence of ABO and D phenotypes was as follows: group O, D+ (38.8%), group O, D– (2.5%), group B, D+ (32.2%), group A, D+ (17.4%), group A, D– (1.7%), and group AB, D+ (7.4%). Of the 242 patients, 232 (95.8%) were D+ and 10 (4.2%) were D–. The most prevalent Rh antigen was found to be e (97%), followed by D (95%), C (89.6%), c (62.8%), and lastly, E (22.6%). The prevalence of Rh phenotypes was: R1R1 (37.7%), R1r (33.4%), R1R2 (19.4%), R2r (5.2%), and rr (4.3 %). All of the D– patients were rr. In our study, the highest prevalence of ABO phenotypes was group O and the most prevalent Rh antigen was e. Rh phenotyping, along with antibody screening and identification should be performed prior to transfusion of patients requiring multiple transfusions to reduce and possibly prevent the rate of alloimmunization.

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1. Sharma DC, Singhal S, Rai S, Iyenger S, Sao S, Jain B. Incidence of Rh antigens, phenotype and probable genotype in the population of Gwalior and Chambal region, Central India. Int Blood Res Rev 2013;1:29–43. 

2. Shakir M, Khan SA, Ghani E. Frequency of ABO and RH (D) blood group systems among blood donors in Rawalpindi/ Islamabad area. PASFMJ 2012;62. Available at http://www.

3. Shahata WM, Khalil HB, Abass A-E, Adam I, Hussien SM. Blood group and Rhesus antigens among blood donors attending central blood bank in Sudan. Sudan JMS 2012;7:245–8.

4. Daniels G, Fletcher A, Garratty G, et al. Blood group terminology 2004: from the International Society of Blood Transfusion committee on terminology for red cell surface antigens. Vox Sang 2004;87:304–16. 

5. Makroo R, Gupta R, Bhatia A, Rosamma NL. Rh phenotype, allele and haplotype frequencies among 51,857 blood donors in North India. Blood Transfus 2014;12:36–9. 

6. EL-Wahhab Skaik YA. The Rh allele frequencies in Gaza city in Palestine. Asian J Transfus Sci 2011;5:150–2. 

7. Singer ST, Wu V, Mignacca R, Kuypers FA, Morel P, Vichinsky EP. Alloimmunization and erythrocyte autoimmunization in transfusion-dependent thalassemia patients of predominantly Asian descent. Blood 2000;96:3369–73. 

8. Zaidi U, Borhany M, Ansari S, et al. Red cell alloimmunisation in regularly transfused beta thalassemia patients in Pakistan. Transfus Med 2015;25:106–10. 

9. Karim F, Moiz B, Mohammad FJ, Ausat F, Khurshid M. Rhesus and Kell phenotyping of voluntary blood donors: foundation of a donor data bank. J Coll Physicians Surg Pak 2015;25: 757–60.

10. Taha JY. Rh antigen and phenotype frequency in Kalba region, UAE. Bahrain Med Bull 2012;34. 

11. Thakral B, Saluja K, Sharma RR, Marwaha N. Phenotype frequencies of blood group system (Rh, Kell, Kidd, Duffy, MNSs, P, Lewis and Lutheran) in North Indian blood donors. Transfus Apher Sci 2010;43:17–22. 

12. Khan MS, Farooq N, Qamar N, et al. Trend of blood groups and Rh factor in the twin cities of Rawalpindi and Islamabad. J Pak Med Assoc 2006;56:299. 

13. Alam M. ABO and Rhesus blood groups in potential blood donors at Skardu (northern areas). Pak J Pathol 2005;16:94–7. 

14. Khattak ID, Khan TM, Khan P, Shah SM, Khattak ST, Ali A. Frequency of ABO and Rhesus blood groups in District Swat, Pakistan. J Ayub Med Coll Abbottabad 2008;20:127–9.

15. Mahmood MA, Anjum AH, Train SM, Shahid R, Usman M, Khawar SH. Pattern of ABO and Rh blood groups in Multan region. Biomedica 2005;2:1–4. 

16. Ali N, Anwar M, Bhatti FA, Nadeem M, Nadeem A, Ali M. Frequency of ABO and Rh blood groups in major ethnic groups and casts of Pakistan. Pak J Med Sci 2005;21:26–9. 

17. Garratty G, Glynn SA, McEntire R. ABO and Rh(D) phenotype frequencies of different racial/ethnic groups in the United States. Transfusion 2004;44:703. 

18. Canadian Blood Services–Société canadienne du sang. Types & Rh System, Canadian Blood Services. Retrieved 2010-11-9.

19. Periyavan S, Sangeetha S, Marimuthu P, Manjunath B, Seema D. Distribution of ABO and Rhesus-D blood groups in and around Bangalore. Asian J Transfus Sci 2010;4:41.

20. Talukdar SI, Das RK. Distribution of ABO and Rh blood groups among blood donors of Dinajpur district of Bangladesh. Dinajpur Med Col J 2010;55:58. 

21. Bashwari LA, Al-Mulhim AA, Ahmad MS, Ahmed MA. Frequency of ABO blood groups in the Eastern region of Saudi Arabia. Saudi Med J 2001;22:1008–12.

22. Pramanik T, Praminic S. Distribution of ABO and Rh blood groups in Nepalese medical students: a report. East Mediterr Health J 2000;6:156–8. 

23. Daniels GL. Human blood groups. 2nd ed. Oxford, UK: Blackwell Science, 2002. 

24. Furqan E, Shamsi TS, Ahmed A, Syed S. Prevalence of Rhesus phenotypes among local population in Karachi. J Pak Med Assoc 1998;48:278–9.