Gereç ve Yöntem: 2022 yılı Uşak Eğitim ve Araştırma Hastanesi Kan Transfüzyon Merkezi’ne 23.209kan grubu ve Rh testi istemi geriye dönük olarak değerlendirildi. 2mL EDTA’lı tüplere alınan örneklerden venöz kan numunesi jel santrifüj metoduyla Across Auto System OCTO-M otoanalizöründeAcross Gel Forward®Reverse ABO withDvı-/Dvı+kitleriyle ABO ve Rh tespit edilmiştir.

Bulgular: Analiz sonrası ARh(+) %37.65, BRh (+) %15.87, ABRh (+)%7.90, ORh(+) %27.88, ARh (-)%4.54, BRh(-)%1.96, ABRh (-)%0.89 ve ORh (-)%3.27 olarak hesaplandı. Bölgemizde sıklığı en yüksek kan grubu ARh (+), en az bulunan ise ABRh (-) olarak tespit edildi. Rh antijeninin yüzdesi ayrı değerlendirildiğinde %89.31 Rh(+) ve %10.68 Rh(-) olduğu tespit edildi.

Sonuç: Uşak ilinde ilk defa yapmış olduğumuz araştırmamızın çıktılarının kan merkezi ve rutin işleyişimize katkı vereceğini bekliyoruz. Bulgularımız Türkiye geneli kan grubu oranları ile yakın düzeylerde çıkmıştır.

Blood donation is utmost in global health systems, with over one hundred million blood units donated annually. Blood transfusion is central for patients dealing with trauma, undergoing surgery, handling chronic ilnesses, and fighting cancer.this basic process assists as alifeline, and saving lives ².

Blood, whose source is human, is a biological tissue with a unique structure and is mostly liquid. Blood transfusion is a form of treatment frequently used in medicine. Due to the differences in the antigen and antibody types found in the structure of blood, blood transfusion is a tissue or even an organ transplant. Before making a medical decision regarding transfusion indication, great care must be taken to ensure a safe transfusion ³.

The main goal of Blood Centers is to obtain and ensure the continuity of safe blood and products, taking into account compatibility tests that will minimize major transfusion reactions and infectious agents that can be transmitted through blood ⁴.

The International Society of Blood Transfusion (ISBT), Red Cell Immunogenetics, and Blood Group Terminology Working Group (ISBT WP) officially registers all blood group patterns known today. Today, there are 43 known blood group models containing 349 erythrocyte antigens (September 2022). The 43 blood group systems are genetically determined by 48 genes ⁵.

ABO grouping test is the most important test performed before transfusion. ABO and RhD group determinations must be made before every transfusion, including antenatal erythrocyte samples. In addition, the results of ABO and RhD grouping tests should be compared with existing records ⁶.

Rates of Rhesus (Rh) and ABO blood group systems vary among races, regions and countries, and even among groups with different ethnic origins in the same region ⁷.

As far as we know, we have not come across any studies on the distribution of blood groups in the Uşak region. The purpose of conducting this research is to determine the existing Rh and ABO blood group rates in our region and to use these results, if necessary, in blood center management processes and daily routine, based on science.

A total of 23.209 Rh and ABO tests that came to the Ministry of Health Uşak Training and Research Hospital Blood Transfusion Center in 2022 were evaluated retrospectively. Results without test data, sample rejection for different reasons, and reverse inappropriate results were excluded from the study. In addition, only one result of people who performed more than one test was included in the study, and repeated tests were excluded from the study. As a result, the number of tests we had was 19.508. Rh and ABO were detected in the across auto system Octo-M autoanalyzer with the sample taken into 2mL tubes containing EDTA, using the gel centrifuge method.

Statistical Analysis: Data entered into Microsoft Excel spreadsheet, and analyzed. Each group and subgroup was calculated as a percentage. Blood group phenotypic frequencies obtained in our study were presented as percentages.

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Table 1: Number and percentages of ABO and Rh individuals.

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Figure 1: Distribution of the percentages of ABO and Rh groups

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Figure 2: Distribution of Rh percentages

The ABO antigen model is formed by the polymorphism of complex carbohydrate molecules of glycolipids and glycoproteins existing on the membranes of red cells. The presence of the ABO gene on chromosome 9 is responsible for the inheritance of different blood subgroup types ¹¹. Following the ABO blood group model, the Rh blood group model is the model containing the "Rh" factor, which causes the most severe immunogenic response. One of the most complex red cell antigen models is the Rh model ¹².

When the levels in Istanbul are examined, in the article published by Gül in 2005; The percentages of A, O, B, and AB were found to be 44.80%, 30.80%, 15.90%, and 8.10%, respectively ¹³. According to the article published by Salduz in 2015 in Istanbul, these percentages are; 43.44%, 33.02%, 15.00%, and 8.54% reported ⁸. When the data of these two articles and our study are compared, the A blood group percentages are very close to each other.

When we compare the results of the study published by Salduz et al. ⁸ in 2015 with the data of the article published by Gül ¹¹ in 2005, in Salduz's report, group A is lower (43.44% compared to 44.80%) and group O is higher (30.80% compared to 33.02%) was found to be present. The change in blood group percentages in these two articles has been associated with the recent increase in immigration to Istanbul.

According to the data of the Turkish Statistical Institute, Uşak province received 13.705 immigrants in 2021. We could not make this comparison because we could not find any other research conducted in our city to compare our results. This can be considered a limitation for our study. However, the data we have reported will provide an opportunity for comparison in future studies on this subject.

There is a study in the literature conducted in Denizli province, which is adjacent to our city, in 2010, reporting Rh positive as 89.9% and Rh negative as 10.1%. In this study, the percentages of A, O, B, AB blood groups were found to be 42.6%, 33.3%, 16.8%, 7.4%, respectively. These rates in both the Rh system and the ABO system were very similar to the rates in our study ¹⁴. This shows that two neighboring provinces are similar in terms of blood group systems.

In the study conducted in Diyarbakır in 2008, blood groups A and AB were found to be slightly lower than our study, blood group O was found to be slightly higher, and blood group B was found to have very similar percentages to ours. It was thought that this difference was due to differences between regions ¹⁵.

The blood group distribution of donors who donated blood to the Kızılay in 2023 is seen as group A (42%), group B (16%), group AB (8%) and group O (34%). If we compare our study with the Kızılay data showing the Turkish average, there is a very close percentage rate in terms of A, B and AB. Only in terms of group 0, Uşak province is 3% lower ¹⁶.

In conclusion, we foresee that researching the distribution rates of blood groups at the regional and country levels will contribute to the fields of general medicine, anthropology, hematology, biochemistry, genetic, immunology and science, and when necessary, these data will be used in blood center management. We also think that it will be beneficial in terms of patient follow-up in daily practice.

We anticipate that the findings of our research, conducted for the first time in Uşak province, will contribute to the transfusion center and routine operation, and will also serve as a database for our country and especially our region.

Acknowledgements
We would like to thank our technicians who perform blood group and Rh tests.

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