S Gerald Sandler1, Susan D Roseff, Ronald E Domen, Beth Shaz, Jerome L Gottschall. 1. From the Department of Pathology and Laboratory Medicine, MedStar Georgetown University Hospital, Washington, DC (Dr Sandler); Department of Pathology, Virginia Commonwealth University School of Medicine, Richmond (Dr Roseff); Department of Pathology, Penn State College of Medicine, Hershey, Pennsylvania (Dr Domen); New York Blood Center, New York, New York (Dr Shaz); and Blood Center of Wisconsin and Department of Pathology, Medical College of Wisconsin, Milwaukee (Dr Gottschall).
Abstract
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.
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.
Authors: Willy A Flegel; Lilian Castilho; Meghan Delaney; Ellen B Klapper; Joann M Moulds; France Noizat-Pirenne; Nadine Shehata; Gary Stack; Christopher A Tormey; Franz F Wagner; Dan A Waxman; Christof Weinstock; Silvano Wendel; Gregory A Denomme Journal: Blood Transfus Date: 2014-12-02 Impact factor: 3.443
Authors: S Gerald Sandler; Willy A Flegel; Connie M Westhoff; Gregory A Denomme; Meghan Delaney; Margaret A Keller; Susan T Johnson; Louis Katz; John T Queenan; Ralph R Vassallo; Clayton D Simon Journal: Transfusion Date: 2014-12-01 Impact factor: 3.157
Authors: Seema Kacker; Ralph Vassallo; Margaret A Keller; Connie M Westhoff; Kevin D Frick; S Gerald Sandler; Aaron A R Tobian Journal: Transfusion Date: 2015-03-21 Impact factor: 3.157