RhD variants in Caucasians: consequences for checking clinically relevant alleles

Hélène Ansart-Pirenne1, Marianne Asso-Bonnet, Pierre-Yves Le Pennec

  • 1National Blood Group Reference Center and the French Establishment of Transfusion of Ile de France, Hôpital Henri Mondor, Créteil, France.

Transfusion
|August 21, 2004
PubMed

Insights

This study identified five new weak D variants, improving understanding of D antigen variations. Genotyping weak D Type 1 and 2 can optimize blood transfusions for carriers.

Area of Science:

  • Hematology
  • Immunogenetics
  • Blood group serology

Background:

  • Weak D type carriers have limited immunization risk unless antigen density is below 400 antigens per red blood cell (RBC).
  • Partial D carriers, however, can produce anti-D antibodies.

Purpose of the Study:

  • To characterize new variants of the D antigen.
  • To investigate the molecular basis of weak D expression and anti-D production.

Main Methods:

  • Serologic and molecular analyses were performed on 168 blood samples from Caucasian individuals.
  • Focus on samples exhibiting weak D expression and/or anti-D production.

Main Results:

  • Identified 70 partial D and 62 weak D cases.
  • Characterized five novel weak D alleles (399G>T, 680T>C, 833G>A, 851C>T, 1015G>A).
  • Weak D Type 1 and 2 alleles showed antigen density up to 500, while new variants and most other weak D variants had densities below 400 antigens/RBC.

Conclusions:

  • Provided molecular characterization of five new D variants.
  • Recommended routine genotyping for weak D Type 1 and 2 in laboratories for serologically weak D antigens.
  • Genotyping can prevent wastage of D- RBC units by enabling safe transfusion of D+ units to carriers.
Abstract

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