Variable reactivity of Rh D antigen and its serological characterization

Area of Science:

• Transfusion Medicine
• Immunohaematology
• Serology

Background:

• Reactivity variations in Rh D typing present interpretation challenges.
• Ambiguity in Rh D typing can impact patient management decisions.

Purpose of the Study:

• To evaluate the prevalence and characterization of variant Rh D phenotypes.
• To assess the efficacy of different testing methods for Rh D typing.

Main Methods:

• Prospective study over 18 months using automated column agglutination technique for Rh D typing.
• Weak D testing via antihuman globulin method for Rh D negative or discrepant samples.
• Partial D phenotyping using a set of 6 monoclonal anti-D antisera.

Main Results:

• 82,824 samples tested; 6.9% Rh D negative, 0.1% discrepant.
• Overall prevalence of variant D was 1.28% in Rh D negative and 0.09% in total population.
• Column agglutination technique showed higher detection rates for variant D phenotypes.

Conclusions:

• Partial D typing kits alone are insufficient for absolute characterization of variant D.
• Extended serological testing is crucial.
• Selective integration of molecular testing is recommended for comprehensive variant D characterization.