Clinical Investigation in Canine and Feline Transfusion Medicine: Novel Blood Groups and their Clinical Significance

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In veterinary medicine, the demand for blood transfusions has increase dramatically in order to support anemic and bleeding patients requiring more and more sophisticated care. Significant knowledge gaps concerning blood banking and blood compatibility in dogs and cats have been filled, but much remains to be investigated. A current concern is the threatened sustainability of blood typing for dogs and cats, and the associated loss of significant transfusion medicine knowledge, because of the lack of a reliable source of blood typing reagents. Our blood bank is a pioneer in veterinary blood transfusion with an exceptional reputation based on the quality of its blood products and of its research/publications, putting us in a unique and privileged position to address such concerns and to pursue research of novel blood groups. Our recent collaboration with the Canadian Animal Blood Bank will also facilitate large-scale clinical investigation. Briefly, dogs have a dozen blood group systems mostly known as dog erythrocyte antigens (DEA), with the most important being DEA 1. First-time transfusion is considered safe without prior cross-matching, as most dogs do not possess naturally-occurring antibodies. That said, mild immunologic incompatibilities of unknown clinical significance have been documented in some transfusion-naive dogs. As multiple blood transfusions recipients are more common, novel blood groups are likely to be identified, likewise the discovery of the Dal blood group. The rarity of Dal-negative phenotype pauses particular challenge as compatible blood is scarce. Except for DEA 1, canine blood typing relies on polyclonal reagents. Because of the limited accessibility of DEA 3, 5 and Dal typing reagents, finding compatible blood for a given patient can be arduous, and further comparative blood typing studies are limited and may become simply impossible. In opposite, the AB blood group system in cats is characterized by well-defined naturally-occurring alloantibodies. In 2007, a novel blood group named Mik was identified in cats. Since then, very little has been published on feline blood compatibility despite the fact that naturally-occurring alloantibodies outside of the AB and Mik system are known to exist. Our preliminary results indicate that 15% of cats possessed such alloantibodies, but their capacity to result in transfusion reactions remains unknown. The work outlined herein will significantly improve blood compatibility knowledge in dogs and cats. First, we will continue to investigate the clinical significance of blood groups in dogs and cats and their related alloantibodies. Second, we aim to provide long-term solution to the sustainability of veterinary blood typing by producing monoclonal typing reagent. Funding this research will improve the safety of transfusion for companion animals by generating tangible guidelines for veterinarians and will facilitate future antigenic and genotypic characterization of blood groups.