RHD genotyping is recommended for all patients with serological weak-D phenotypes in Asian populations - Cases with coexistence of weak-D and Asia type DEL alleles results in complete expression of D-antigen
- Authors
- Chun, S[Chun, Sejong]; Kim, H[Kim, Hyungsuk]; Yun, JW[Yun, Jae Won]; Yu, H[Yu, HongBi]; Seo, JY[Seo, Ji Young]; Cho, D[Cho, Duck]
- Issue Date
- Aug-2020
- Publisher
- PERGAMON-ELSEVIER SCIENCE LTD
- Keywords
- RHD genotype; RhD; Weak D; Anti-D; Rho(D) immune globulin; Alloimmunization
- Citation
- TRANSFUSION AND APHERESIS SCIENCE, v.59, no.4
- Indexed
- SCIE
SCOPUS
- Journal Title
- TRANSFUSION AND APHERESIS SCIENCE
- Volume
- 59
- Number
- 4
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/3647
- DOI
- 10.1016/j.transci.2020.102807
- ISSN
- 1473-0502
- Abstract
- Weak D types 1, 2, 3 and Asia type DEL (RHD 1227 G > A) can be treated as D-positive for purposes of Rho(D) immune globulin (RhIG) administration or selection of blood components for transfusion. To confirm these D variants, RHD genotyping can be used as a complementary to serologic tests. While ruling out weak D types 1,2,3 is useful in Caucasian populations, these are extremely rare in the Asian population, while Asia type DEL is relatively common. Distinguishing between true D-negative and Asia type DEL (RHD 1227 G > A) by genotyping has the same utility of distinguishing weak D types 1, 2, 3. The main difference between weak D and Asia type DEL is that the latter appears as D negative in conventional serologic methods, while the former will show positive in indirect anti-human immunoglobulin tests. RHD genotyping in apparent D-negative Asian patients has been established, yet the utility of genotyping in Asian patients with weakened D phenotypes require further investigation. We have observed cases of weak D patients with coexistence of a weak D allele and an Asia type DEL (RHD 1227 G > A) allele, we have found that antigen expression of D is as the weak D in indirect antiglobulin testing, yet all epitopes are detected with adsorption and elution assays. This is indicative of completeness of the D antigen epitope, and thus we suggest that all Asian patients with weakened D phenotypes can benefit from RHD genotyping.
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Collections - Medicine > Department of Medicine > 1. Journal Articles
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