Experimental Studies on the Prevention of Rh Haemolytic Disease

Evaluation of the clinical utility of maternal alloantibody screening as a surrogate to antiglobulin crossmatch procedures in resource limited settings

“…Prevention of RhD HDFN became feasible in the late 1960s after pioneering research by Finn Clarks and Freda; there was a dramatic decline in Rh HDFN [19,20]. Since then other Rh and nonRh red cell alloantibodies have become relatively more important and are now responsible for the greater proportion of the HDFN cases.…”

Cyril Clarke and the prevention of rhesus haemolytic disease of the newborn

“…He also noted an association between the development of Rh antibodies and the size of these fetal bleeds into the maternal circulation. Furthermore, fetal cells were never found in maternal blood when the fetus and mother were ABO incompatible (Finn et al, 1961). Therefore it was possible that circulating Rh-positive fetal cells in an Rh-negative mother might be similarly eliminated by the administration of anti-D, thus preventing Rh sensitization of the mother.…”

“…On several occasions Cyril suggested that it was his wife Feo, who woke up in the middle of the night after a dream and shouted 'give them anti-D' (Clarke, 1968)! However, the first published suggestion of this possibility appeared in a short account of a paper that Finn gave at a symposium on The Role of Inheritance in Common Diseases that was held at the Liverpool Medical Institution on February 18th 1960, the abstract of which was later published in Lancet (Finn, 1960). When this issue was raised at the Wellcome Witness Seminar on The Rhesus Factor and Disease Prevention (Zallen et al, 2004) Finn suggested that, because Feo edited and classified all the published work from Cyril's group at the time, and he had organized and run this symposium, she might have come across this abstract and mentioned it to Cyril but he was far from sure whether she had actually suggested this approach.…”

“…During this period both Finn and Woodrow carried out similar experiments at Johns Hopkins Hospital, Baltimore with the help of Julius Krevans; in this case the male volunteers were prisoners in the Baltimore penitentiary. After seminal papers summarizing these results (Finn et al, 1961;Clarke et al, 1963;Woodrow et al, 1965) Cyril's team felt that they were now ready to perform a full-scale clinical trial for the prevention of Rhesus sensitization in pregnant women.…”

17 Rhesus Isoimmunization

“…The important factors in obtaining such protection are rapid clearance of the Rh-positive cells from the circulation and the use of anti-D without saline activity (Finn et al 1961). …”