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BBTS Chapter 8 Other Blood Group Systems > Kell > Flashcards

Kell Flashcards

1
Q

How many antigens are there in the Kell blood group?

A

35

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2
Q

What type of membrane structure is the Kell antigen?

A

Single-pass glycoprotein that is highly folded

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3
Q

How many amino acids does the Kell antigen have?

A

732

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4
Q

How is the Kell antigen made?

A

KEL gene on chromosome 7

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4
Q

How is the Kell antigens affected by papain enzyme treatment?

A

Resistant but with variable reactions, e.g. pos reaction by IAT but weaker or undetected by ENZ

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5
Q

When are the Kell antigens formed?

A

Present in the early fetal life and well developed at birth

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5
Q

Which are the two major antibodies commonly encountered?

A

K and k (cellano)

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5
Q

Are K and k codominant?

A

Yes

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5
Q

What amino acid is needed to make the K antigen?

A

Methionine

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6
Q

How many amino acid change is there between K and k?

A

1

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6
Q

What amino acid is needed to make the k antigen?

A

threonine

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7
Q

At what position is the amino acid change between K and k?

A

193

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8
Q

What is the % frequency of K+k- (KK genotype) in the black population?

A

0%

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9
Q

What is the % frequency of K+k- (KK genotype) in the white population?

A

0.2%

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10
Q

What is the % frequency of K+k+ (Kk genotype) in the black population?

A

1.5%

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11
Q

What is the % frequency of K+k+ (Kk genotype) in the white population?

A

8.8%

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12
Q

What is the % frequency of K-k+ (kk genotype) in the black population?

A

91%

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13
Q

What is the % frequency of K-k+ (kk genotype) in the white population?

A

98.5%

14
Q

Is K clinically significant?

A

Yes, most immunogenic antigen after RhD so often seen in transfusion recipients. Anti-K can be on its own or in conjunction with other antibodies.
Severe transfusion reaction and severe HDFN

15
Q

What other Kell antigens are often seen?

A

Kpa
Kpb
Jsa
Jsb

16
Q

What type of immunoglobulin are the Kell antigens mentioned?

A

IgG

17
Q

Can the Kell antigens activate complement?

A

Unlikely and rare with anti-K

18
Q

What is the optimal technique to detect the Kell antigens?

A

IAT at 37oC

19
Q

Which of the Kell antibodies are capable of initiating a transfusion reaction and HDFN?

A

anti-K
anti-k
anti-Jsa
anti-Jsb

20
Q

What is the % occurrence of the K antigen in the black population?

A

1.5%

21
Q

What is the % occurrence of the K antigen in the white population?

A

9%

22
Q

What is the % occurrence of the k antigen in the black population?

A

100%

23
Q

What is the % occurrence of the k antigen in the white population?

A

99.8%

24
Q

What is the % occurrence of the kpa antigen in the black population?

A

0%

25
Q

What is the % occurrence of the kpa antigen in the white population?

A

2%

26
Q

What is the % occurrence of the kpb antigen in the black population?

A

100%

27
Q

What is the % occurrence of the kpb antigen in the white population?

A

> 99.9%

28
Q

What is the % occurrence of the Jsa antigen in the black population?

A

20%

29
Q

What is the % occurrence of the Jsa antigen in the white population?

A

<0.01%

30
Q

What is the % occurrence of the Jsb antigen in the black population?

A

99%

31
Q

What is the % occurrence of the Jsb antigen in the white population?

A

100%

32
Q

Why is it not essential to have a rarer phenotype K+k- red cells for antibody screening or ABID panels?

A

Anti-K is typically avid and will react strongly with K+k+ and K+k-

33
Q

How would you provide RBC to a patient with anti-K or anti-k?

A

Antigen negative crossmatch compatible at 37oC

34
Q

How easy is it to get antigen negative blood for K and k?

A

K = easy as 9/10 donors will be K neg in UK and all units are antigen K typed
k = difficult (HFA) 1/500 donors

35
Q

Is anti-Kpa clinically significant?

A

Sometimes e.g. in pregnancy. Can cause transfusion reactions and HDFN with mild to severe cases but rare so Kpa neg cells is not necessary for antibody screening

36
Q

Why is anti-Kpb considered a nuisance antibody?

A

Because the majority of the population is Kpb antigen positive so will react with almost all donations therefore it is very difficult to source Kpb negative blood

37
Q

How common is anti-Jsa and Jsb?

A

In the UK it is uncommon because the nature of the donor population most patient and donor is Js(a-b+). But if present must be treated as clinically significant

38
Q

What causes the Kell null phenotype (Ko)?

A

Homozygous inheritance of non-functioning KEL genes resulting in absence of entire KELL glycoprotein

39
Q

What would happen if a Ko patient is transfused with a non Ko RBC unit?

A

They can make anti-Ku which is clinically significant causeing both transfusion reactions and HDFN. Can also be made through pregnancy.

BBTS Chapter 8 Other Blood Group Systems (4 decks)

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