Qing-Ping Wang1, Guang-Tao Dong2, Xue-Dong Wang3, Juan Gu3, Zheng Li4, An-Yuan Sun5, Chao-Peng Shao6, Zhao-Lin Pan3, Li-Hua Huang3, Wei-Xing Xie3, Guang-Ming Sun7, Jian-Jiang Chen1, Hao Pei3, Xiao-Juan Yang3, Ping-Nan Shan8. 1. Department of Clinical Laboratory, the Shaoxing Hospital of China Medical University, Shaoxing, Zhejiang, People's Republic of China. 2. Department of Emergency Medicine, the First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, People's Republic of China. 3. Department of Clinical Laboratory, the Fifth People's Hospital of Wuxi, the Affiliated Hospital of Nanjing Medical University, Wuxi, Jiangsu, People's Republic of China. 4. Department of Clinical Laboratory, the Affiliated Hospital of Guilin Medical College, Guilin, Guangxi, People's Republic of China. 5. Department of Clinical Laboratory, the Affiliated Provincial Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China. 6. Shenzhen Blood Center and Institute of Blood Transfusion Medicine, Shenzhen, Guangdong, People's Republic of China. 7. Zhenjiang Maternal and Children Health Care Hospital, The Fourth Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, People's Republic of China. 8. Department of Blood Transfusion, the Shaoxing Hospital of China Medical University, Shaoxing, Zhejiang, People's Republic of China.
Abstract
BACKGROUND: Despite the introduction of anti-D prophylaxis into clinical practice, RhD alloimmunisation remains a problem, particularly in the context of transfusions and pregnancy-induced alloimmunisation. The incidence of RhD alloimmunisation among phenotypically RhD-negative individuals is unknown in most countries. We investigated RhD alloimmmunisation in RhD-negative pregnant women and transfusion recipients in south-east China in order to optimise the prevention of this phenomenon. METHODS: We analysed the RhD alloimmunisation status of RhD-negative pregnant women and transfusion recipients in south-east China. The RhD blood types of the study population were identified by standard serological methods. The D antigen was further tested with the indirect antiglobulin test to exclude or confirm weak D or partial D types. RhC, c, E and e antigens were typed in all subjects. If anti-D antibody screening was positive, the specificity and titre of the antibody were determined. The Del phenotype was investigated by the polymerase chain reaction sequence-specific primer method. RESULTS: An anti-D antibody was found in 61 of 416 RhD-negative pregnant women (14.66%), and in 11 of 227 RhD-negative transfusion recipients (4.85%). None of the 72 RhD-negative pregnant women or transfusion recipients with anti-D had the Del phenotype. Anti-D antibodies were not detected among Del phenotype individuals and Del phenotypes were not found in anti-D antibody producing individuals. DISCUSSION: Our study suggests that the risk of alloimmunity-induced neonatal haemolysis increases in true RhD-negative multipara. Perinatal protection would be necessary in these patients, while antenatal anti-D testing and Rh immune globulin prophylaxis would be unnecessary for RhDel pregnant women. Pregnant women and transfusion recipients with the Del type seldom produce anti-D antibody. RhD-negative recipients are not at risk of alloimmunisation after transfusion with Del red blood cells.
BACKGROUND: Despite the introduction of anti-D prophylaxis into clinical practice, RhD alloimmunisation remains a problem, particularly in the context of transfusions and pregnancy-induced alloimmunisation. The incidence of RhD alloimmunisation among phenotypically RhD-negative individuals is unknown in most countries. We investigated RhD alloimmmunisation in RhD-negative pregnant women and transfusion recipients in south-east China in order to optimise the prevention of this phenomenon. METHODS: We analysed the RhD alloimmunisation status of RhD-negative pregnant women and transfusion recipients in south-east China. The RhD blood types of the study population were identified by standard serological methods. The D antigen was further tested with the indirect antiglobulin test to exclude or confirm weak D or partial D types. RhC, c, E and e antigens were typed in all subjects. If anti-D antibody screening was positive, the specificity and titre of the antibody were determined. The Del phenotype was investigated by the polymerase chain reaction sequence-specific primer method. RESULTS: An anti-D antibody was found in 61 of 416 RhD-negative pregnant women (14.66%), and in 11 of 227 RhD-negative transfusion recipients (4.85%). None of the 72 RhD-negative pregnant women or transfusion recipients with anti-D had the Del phenotype. Anti-D antibodies were not detected among Del phenotype individuals and Del phenotypes were not found in anti-D antibody producing individuals. DISCUSSION: Our study suggests that the risk of alloimmunity-induced neonatal haemolysis increases in true RhD-negative multipara. Perinatal protection would be necessary in these patients, while antenatal anti-D testing and Rh immune globulin prophylaxis would be unnecessary for RhDel pregnant women. Pregnant women and transfusion recipients with the Del type seldom produce anti-D antibody. RhD-negative recipients are not at risk of alloimmunisation after transfusion with Del red blood cells.
Authors: Thomas Wagner; Günther F Körmöczi; Christoph Buchta; Maria Vadon; Gerhard Lanzer; Wolfgang R Mayr; Tobias J Legler Journal: Transfusion Date: 2005-04 Impact factor: 3.157
Authors: Tae Yeul Kim; Yun Ji Hong; Mi Jung Kim; Hyungsuk Kim; Taek Soo Kim; Jeong Su Park; Kyoung Un Park; Kyou-Sup Han Journal: Transfus Med Hemother Date: 2019-05-17 Impact factor: 3.747