Identification of RHD alleles with the potential of anti‐D immunization among seemingly D− blood donors in Upper Austria

  title={Identification of RHD alleles with the potential of anti‐D immunization among seemingly D− blood donors in Upper Austria},
  author={Helene Polin and Martin Danzer and Waltraud Gaszner and Doris Broda and Maryse St‐Louis and Johannes Pr{\"o}ll and Katja Hofer and Christian Gabriel},
BACKGROUND: Aberrant RHD alleles leading to a reduced expression of D antigen on the red blood cell (RBC) surface may be mistyped as D− by serology. To quantify the occurrence of weak D, DEL, and D+/− chimera among apparent D− first‐time blood donors, polymerase chain reaction (PCR) screening was implemented as a routine service. 

RHD Allelic Identification Among D−Brazilian Blood Donors as a Routine Test Using Pools of DNA

RHD alleles leading to a reduced expression of D antigen of the red blood cell (RBC) surface may be erroneously typed as D− by serology and may cause anti‐D immunizations when transfused to

RHD variants in Polish blood donors routinely typed as D–

The aim was to estimate the frequency of RHD alleles among the apparently D– Polish donor population and to characterize its molecular background.

On the trail of anti‐CDE to unexpected highlights of the RHD*weak 4.3 allele in the Upper Austrian population

A comprehensive serological and molecular work‐up of a novel haplotype carrying the RHD*weak 4.3 in combination with an aberrant RHCE*ce is introduced.

The RHD(1227G>A) DEL‐associated allele is the most prevalent DEL allele in Australian D– blood donors with C+ and/or E+ phenotypes

Red blood cells with D antigen levels only detected by anti‐D adsorption‐elution and an antiglobulin test express a DEL phenotype, and the prevalence of DEL‐associated RHD alleles in a cohort of Australian D– donors is measured to develop a model to estimate alloimmunization risk.

RHD PCR of D-Negative Blood Donors

  • F. Wagner
  • Medicine, Biology
    Transfusion Medicine and Hemotherapy
  • 2013
Probably, the most cost-efficient implementation is replacement of sensitive D antigen testing with the indirect antiglobulin test by RHD PCR in pools which might even reduce total testing cost.

Is current serologic RhD typing of blood donors sufficient for avoiding immunization of recipients? (CME)

It is central to identify the extent of D antigens that escape routine RhD typing of blood donors and to improve methodology if necessary to avoid immunization with clinically important antibodies.

Weak D and DEL alleles detected by routine SNaPshot genotyping: identification of four novel RHD alleles

The purpose of the work was to develop a multiplex polymerase chain reaction SNaPshot assay for simultaneous detection of weak D and DEL alleles that are prevalent in Europeans, Africans, and Asians.

RHD genotyping of serologic RhD‐negative blood donors in a hospital‐based blood donor center

The aim of this study was to determine the frequency of RHD variant alleles in serologic RhD‐negative blood donors at a hospital‐based donor center in Los Angeles.

First description of a D‐CE‐D hybrid gene on a weak D Type 2 molecular background

The molecular identification of weak D Type 1, 2, or 3 carriers allows managing them as RhD‐positive and rationalizes the use of Rh D‐negative stock units and the administration of Rh‐immunoglobulin prophylaxis, avoiding unnecessary costs and possible side effects.

The Experience of RHD Genotyping in D-negative Blood Donors

Seventy-four cases of serologic D negative donors were reclassified as RHD variants by RHD genotyping, believed to have contributed to the improvement of transfusion safety by lowering the risk of anti-D alloimmunization in D-negative patients.



A comprehensive analysis of DEL types: partial DEL individuals are prone to anti‐D alloimmunization

The least expressed D variants collectively called DEL are serologically detectable only by adsorption‐elution techniques, with so far only poorly defined antigenic properties.

Partial D, weak D types, and novel RHD alleles among 33,864 multiethnic patients: implications for anti‐D alloimmunization and prevention

BACKGROUND: The D antigen includes category D, partial D, and weak D types, which are important because anti‐D alloimmunization can occur in some but not all persons that express a variant RHD

Secondary anti‐D immunization by Del red blood cells

This work has shown that Del individuals retain a grossly intact RHD gene or have a portion of RHD in their genomes, and no Del phenotype has yet been shown to induce a primary or secondary alloanti‐D immunization.

Effective molecular RHD typing strategy for blood donations

A real time–based RHD typing scheme was developed and tested during an 8‐month period and identified several weak D alleles that can be identified by molecular methods as polymerase chain reaction (PCR) and DNA sequencing of the RHD gene.

Primary anti‐D immunization by weak D type 2 RBCs

This work has shown that the weak D phenotypes are caused by a large number of distinct RHD alleles generally encoding altered D proteins, and no particular molecular weak D type has yet been shown to induce anti‐D.

Presence of RHD in serologically D–, C/E+ individuals: a European multicenter study

RHD blood group alleles with reduced or absent antigen expression are a clinically significant and heterogeneous group and should be considered a clinical indication for further studies.

RHD positive haplotypes in D negative Europeans

The results of this study allowed to devise an improved RHD genotyping strategy, the false-positive rate of which was lower than 1:10,000 and the number of characterized RHD positive antigen D negative and Del alleles was more than doubled and their population frequencies in Europe were defined.

Molecular background of Rh D‐positive, D‐negative, Del and weak D phenotypes in Chinese

The genetic background of D‐negative and Del in the Chinese population is elucidated and it is found that D‐ negative and Del are more common in the female population than the male population.

Molecular genotyping for RHD: What (not) to do?

In this issue of TRANSFUSION, Polin and colleagues report their approach to molecular testing for RHD, which characterized RHD alleles in 201 samples in which the RBCs were weakly reactive with anti-D and screened samples from 2427 D– donors for the presence of the RHD gene to identify any with low levels of D not detected by serologic testing.

A new DEL variant caused by exon 8 deletion

Molecular biology analysis showed that a 28‐year‐old woman of Lebanese origin, who experienced two stillbirths, was in fact RHD+.