Duffy Blood Group
system
Muhammad Asif Zeb
Lecturer Hematology
IPMS-KMU
The Duffy blood group system was named for Mr. Duffy, a
multiply transfused hemophiliac who in 1950 was found to
have the first described example of anti-Fya.
One year later the antibody defining its antithetical antigen,
Fyb, was described by Ikin et al in the serum of a woman who
had had three pregnancies.
In 1955 Sanger et al reported that the majority of African
Americans tested were Fy(ab). The gene responsible for this
null phenotype was called Fy.
FyFy appeared to be a common genotype in blacks,
especially in Africa; the gene is exceedingly rare in whites.
The Duffy system officially comprises six
antigens Fy1,2,3,4,5,6 that reside on a
glycoprotein encoded by the Duffy gene
(DARC), which consists of two exons, with
exon 1 .
DARC is on chromosome 1q23
Basic Concepts
Fya and Fyb Antigens
The Duffy antigens most important in routine blood bank
serology are Fya and Fyb.
They can be identified on fetal RBCs as early as 6 weeks
gestational age and are well developed at birth.
The antigens have not been found on platelets,
lymphocytes, monocytes, or granulocytes,
but they have been identified in other body tissues,
including brain, colon, endothelium, lung, spleen,
thyroid, thymus, and kidney cells.
The frequencies of the common phenotypes
in the Duffy system are given in Table
Genetics
Duffy gene is located on chromosome 1,
The gene is located near the centromere on the
long arm of the chromosome at position 1q
The Fy locus is syntenic to Rh, which is located near
the tip of the short arm;
There are three common alleles at the Fy locus: Fya
and Fyb that encode the antithetical antigens Fya
and Fyb, respectively, and a silent allele, Fy, that is
the major allele in blacks.
Anti-Fya and Anti-Fyb
Anti-Fya is a common antibody and is found
as a single specificity or in a mixture of
antibodies.
Anti-Fya occurs three times less frequently
than anti-K.
Anti-Fyb is 20 times less common than anti-
Fya and often occurs in combination with
other antibodies.
[The Fya antigen appears to be mor
immunogenic in Fy(a-b+) whites than in
Fy(a-b+) blacks,
The antibodies are usually IgG and react
best at the antiglobulin phase.
Some examples of anti-Fya and anti-Fyb
bind complement.
A few examples are saline agglutinins.
Anti-Fya and anti-Fyb have been associated
with acute and delayed hemolytic
transfusion reactions.
Once the antibody is identified, Fy(a) or
Fy(b) blood must be given; finding such
units in a random population is not difficult.
Anti-Fya and anti-Fyb are associated with
HDN ranging from mild to severe.
