Genotyping of KEL1 and KEL2 of the human Kell blood group system by the polymerase chain reaction with sequence-specific primers.

Background: Kell is a major antigenic system in human red cells, with more than 20 identified antigens. KEL1 and KEL2 are two opposing low- and high-frequency alleles. Immunization to KEL1 is clinically significant, because anti-KEL1 can cause severe reactions to transfusion of incompatible blood, as well as hemolytic disease of the newborn. At the nucleotide level, the difference between the KEL2 and KEL1 alleles is a single-base change within exon 6 that results in the substitution of methionine (ATG) for threonine (ACG) at position 193.

Study Design And Methods: An assay using polymerase chain reaction and sequence-specific primers to genotype for the KEL1 and KEL2 alleles has been developed. It uses two allele-specific forward primers for either KEL1 or KEL2 and a single reverse-consensus primer.

Results: A validation study of 42 serologically typed samples (5 KEL:1,-2 [K+k-]; 23 KEL:1,2 [K+k+]; and 14 KEL:-1,2 [K-k+]) was performed. A concordance rate of 100 percent (42/42 samples) was observed between polymerase chain reaction with sequence-specific primers and serologic typing.

Conclusion: This rapid, nonradioactive, Kell system genotyping assay does not require the additional steps of probe hybridization or restriction enzyme digestion. This application of polymerase chain reaction with sequence-specific primers should prove particularly useful in Kell system genotyping of amniotic cells to identify pregnancies at risk for hemolytic disease of the newborn.