Correlation between serology and genetics of weak D types in Denmark

To date more than 100 variant D types have been reported and the frequencies vary among populations. Blood donor typing should reveal all donors expressing D antigens, while patient typing should prevent the development of anti-D in patients with a D- or variant D blood type. Serotyping is the standard method to assign transfusion strategies, whereas molecular classification offers a more specific grouping of weak and partial D.

Blood donor and patient samples with discrepant results of D phenotyping were collected to investigate the frequency of weak D subtypes in Denmark and to evaluate currently used serologic methods.

Nine different weak D types were identified among the 101 samples. Weak D Types 1, 2, and 3 constituted 80 percent of the analyzed samples and 10 percent of the samples identified as weak D from serology were actually partial D.

The distribution of weak D types in Denmark was found to resemble the distribution in Northern Germany in respect to the three most prevalent weak D types. Correctly defining all samples that show weak reactions in D typing as weak D or partial D is not possible with serotyping alone; genotyping offers the only exact categorization. Serology is superior for routine blood typing, however.