Do we need to be more concerned about weak D antigens?

Garratty, George

doi:10.1111/j.1537-2995.2005.00625.x

Cited by 78 publications

(83 citation statements)

References 49 publications

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“…50 The number of individuals of white race/ethnicity who have inherited a weak D phenotype is estimated to be 0.2% to 1%. 51 Of these, approximately 95% have an RHD allele that has not been associated with forming anti-D. 17,42 The prevalence of weak D phenotypes varies considerably by race, ethnic group, and geography. [52][53][54][55][56][57][58] Emigrants (or their descendants) from Africa, Asia, or other distant geographic areas where certain unique RHD genotypes occur are increasingly present in blood donor services in the United States.…”

Section: Commentmentioning

confidence: 99%

Policies and Procedures Related to Testing for Weak D Phenotypes and Administration of Rh Immune Globulin: Results and Recommendations Related to Supplemental Questions in the Comprehensive Transfusion Medicine Survey of the College of American Pathologists

Sandler

Roseff

Domen

et al. 2014

Archives of Pathology &Amp; Laboratory Medicine

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Context.—Advances in RHD genotyping offer an opportunity to update policies and practices for testing weak D phenotypes and administration of Rh immune globulin to postpartum women. Objectives.—To repeat questions from a 1999 College of American Pathologists proficiency test survey, to evaluate current practices for testing for weak D and administration of Rh immune globulin, and to determine whether there is an opportunity to begin integrating RHD genotyping in laboratory practice. Design.—The College of American Pathologists Transfusion Medicine Resource Committee sent questions from the 1999 survey to laboratories that participated in the 2012 proficiency test survey. The results of the 2012 survey were compared with those from 1999. Results from published RHD genotyping studies were analyzed to determine if RHD genotyping could improve current policies and practices for serological Rh typing. Results.—More than 3100 survey participants responded to the 2012 questions. The most significant finding was a decrease in the number of transfusion services performing a serological weak D test on patients as a strategy to manage those with a weak D as Rh negative (from 58.2% to 19.8%, P < .001). Data from RHD genotyping studies indicate that approximately 95% of women with a serological weak D could be managed safely and more logically as Rh positive. Conclusions.—Selective integration of RHD genotyping policies and practices could improve the accuracy of Rh typing results, reduce unnecessary administration of Rh immune globulin in women with a weak D, and decrease transfusion of Rh-negative red blood cells in most recipients with a serological weak D phenotype.

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Section: Commentmentioning

confidence: 99%

Policies and Procedures Related to Testing for Weak D Phenotypes and Administration of Rh Immune Globulin: Results and Recommendations Related to Supplemental Questions in the Comprehensive Transfusion Medicine Survey of the College of American Pathologists

Sandler

Roseff

Domen

et al. 2014

Archives of Pathology &Amp; Laboratory Medicine

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“…The sequence of RH genes may vary between different ethnic groups. It is important to be aware of the differences in genetic sequences in order to develop genotyping methods that are reliable in a multiracial population [10].…”

Section: Brief Communication (Original)mentioning

confidence: 99%

RH genotypes among Malaysian blood donors

Musa

Hassan²,

Ayob³

et al. 2014

Asian Biomedicine

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Background: RH genotyping studies have been conducted mainly in people of Caucasian and African descent. There is limited information regarding the molecular basis for RH genotypes in Malaysia. Objectives: To investigate the prevalence and characteristics of RHCE genotypes among different ethnic groups in Malaysia. Methods: A total of 1014 whole blood samples were obtained from donors from 4 different ethnic groups (360 Malays, 434 Chinese, 164 Indians, and 56 others). All samples were phenotyped for C, c, D, E, and e using standard serologic methods and genotyped using polymerase chain reaction (PCR)-based analysis. Results:In the blood samples that we analyzed, the distribution of RH genotype antigens was significantly different among the various ethnic groups. Our findings showed that CCDee is the most common in Malaysian blood donors; 18.4% (187/1014) compared with other genotypes. The ccDEE genotype is more prevalent in the Chinese: 65.6% (82/125), and the ccee genotype is more prevalent in Indians: 47.1% (65/138). There were discrepancies between phenotypes and genotypes. There were 17 (1.7%) discrepancies in RH C/c genotyping results and of these 47% (8/17) occurred in Malays. Discrepancies in RH E/e results occurred in 3 samples (0.3%). Conclusions: Our study provides a database for the distribution of RH genotypes of donors from the major ethnic groups in Malaysia. Methods used in this study are useful for comparing the phenotypes and genotypes. Further investigation should be conducted to study the causes of these discrepancies using other molecular based techniques.

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“…Of the Rh-D negative persons 14 (0.037%) turned out to be weak-D positive (Table 3). 6 Later, Race et al 7 and Stratton et al 6 studied this antigen further and showed that it was an inherited characteristic. Unlike the incidence of Rh D antigen positivity in the Caucasian population which is 85%, 8,9 it is around 95% in India.…”

Section: Resultsmentioning

confidence: 99%