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Background: Various issues can arise during blood transfusion, including red blood cell alloimmunization due to incompatible blood units. For example, anti-S and anti-s antibodies can lead to hemolytic transfusion reactions. Therefore, extended phenotyping is necessary for various blood groups other than ABO and RhD antigens, especially for multiply transfused patients such as patients with sickle cell disease. This study aimed to analyze the fre-quencies of the S and s antigens and phenotypes among the healthy blood donors.
Methods: A cross-sectional observational study was conducted by retrieving the registries of healthy blood donors. Blood donations were performed at the blood bank of King Abdulaziz Medical City - Western Region (KAMC-WR), Jeddah, Saudi Arabia. Serological analysis was performed for S and s antigens based on solid phase technique.
Results: A total of 27,027 healthy blood donors were enrolled in this study. Out of these, Saudi and non-Saudi blood donors accounted for 83.64% and 16.36%, respectively. The rates of S and s antigens among Saudis were 59.70% and 84.07, respectively. In contrast, the frequencies in non-Saudis were 54.53% and 87.11%, respectively. Regarding the phenotypes, S+s+ was the most prevalent among Saudi Arabians, with 43.89%, followed by S-s+ (40.18%), S+s- (15.81%), and S-s- (0.12%). The distribution in non-Saudis was as follows: S-s+ at 45.22%, S+s+ at 41.89%, S+s- at 12.64%, and S-s- at 0.25%. The frequencies of the phenotypes showed a statistically significant difference between Saudis and non-Saudis (p < 0.01).
Conclusions: The incidences of the S and s antigens and phenotypes have been reported in both populations. We highly recommend to extend the transfusion screening panel to include the S and s antigens to preclude the red blood cell alloimmunization to these antigens.
DOI: 10.7754/Clin.Lab.2025.250681
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