Six years' experience performing RHD genotyping to confirm D- red blood cell units in Germany for preventing anti-D immunizations

被引:108
作者
Flegel, Willy A. [1 ]
von Zabern, Inge
Wagner, Franz F.
机构
[1] Univ Hosp Ulm, Inst Klin Transfus Med & Immungenet Ulm, German Red Cross DRK Blood Donor Serv Baden Wurtt, Inst Ulm, D-89081 Ulm, Germany
关键词
WEAK-D; POPULATION FREQUENCY; SEROLOGICALLY D; D-EL; GENE; FRAMESHIFT; MUTATION; INDIVIDUALS; ALLELES; DONORS;
D O I
10.1111/j.1537-2995.2008.01975.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Red blood cell (RBC) units of D+ donors are falsely labeled D- if regular serologic typing fails to detect low D antigen expression or chimerism. The limitations of serology can be overcome by molecular typing. In January 2002, we introduced a polymerase chain reaction (PCR)-based assay for RHD as a routine test for first-time donors who typed D- by serologic methods including the indirect antiglobulin test. Samples were tested in pools of 20 for the RHD-specific polymorphism in Intron 4. RHD alleles were identified by PCR and nucleotide sequencing. Within 6 years, 46,133 serologically D- first-time donors were screened for the RHD gene. The prevalence of RHD gene carriers detected by this method was 0.21 percent. Twenty-three RHD alleles were found of which 15 were new. Approximately one-half of the RHD gene carriers harbored alleles expressing a DEL phenotype resulting in a prevalence of 0.1 percent. The integration of RHD genotyping into the routine screening program was practical. We report 6 years' experience of this donor testing policy, which is not performed in most transfusion services worldwide. RBC units of donors with DEL phenotype have been reported to anti-D immunize D- recipients. We transferred those donors to the D+ donor pool with the rationale of preventing anti-D immunizations, especially dreaded in pregnancies. For each population, it will be necessary to adapt the RHD genotyping strategy to the spectrum of prevalent alleles.
引用
收藏
页码:465 / 471
页数:7
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