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Related Experiment Videos

Primary anti-D immunization by weak D type 2 RBCs.

W A Flegel1, S R Khull, F F Wagner

  • 1Department of Transfusion Medicine, University of Ulm, Germany. waf@ucsd.edu

Transfusion
|April 25, 2000
PubMed
Summary
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Weak D type 2 blood, despite low D antigen density, can cause alloanti-D immunization in transfusion recipients. This finding confirms that even minimal D antigen expression can trigger an immune response, impacting blood transfusion safety.

Area of Science:

  • Transfusion Medicine
  • Immunology
  • Genetics

Background:

  • The D antigen is the most immunogenic blood group antigen.
  • Weak D phenotypes, caused by various RHD alleles, present altered D proteins.
  • The D antigen density threshold for anti-D immunization remains unknown.

Observation:

  • A D- recipient developed anti-D antibodies after receiving D+ (weak D type 2) red blood cells.
  • The implicated donor unit expressed approximately 450 D antigens per red blood cell.
  • The recipient developed alloanti-D, confirmed by direct antiglobulin test and serum analysis.

Findings:

  • This case provides definitive evidence that weak D type 2 red blood cells can induce alloanti-D immunization.
  • Weak D type 2 exhibits the lowest D antigen density among prevalent weak D types in white populations.

Related Experiment Videos

  • The study highlights the immunogenicity of even low levels of D antigen expression.

    • Implications:

    • Blood units with weak D type 2 phenotype should be labeled as D+ to prevent immunization.
    • Accurate identification and labeling of weak D types are crucial for transfusion safety.
    • Weak D type 2 may serve as a valuable marker for quality assurance in blood banking.