Elimination of pretransfusion RhD typing at Mackay Memorial Hospital, Taiwan-30-year experience (1988-2017).

Abstract

BackgroundThe frequency of the RhD negative (D‐) phenotype among the population of Taiwan is only 0·34% and so anti‐D is a relatively rare antibody. Routine pretransfusion D typing of patients at Mackay Memorial Hospital (MMH) was discontinued in 1988, and this report is a look back and retrospective evaluation over 30‐years (1988–2017).Study Design and MethodsThe incidence of anti‐D among patients at MMH during the periods 1984–1988 (when D typing was performed) and 1988–2017 (when D typing was not performed) was reviewed. Also, the incidence of anti‐D among both MMH patients and voluntary blood donors at the Taiwan Blood Foundation was compared. The importance of anti‐‘Mia’ in Taiwan is also discussed.ResultsThe incidence of anti‐D relative to other Rh antibodies among MMH patients when D typing was performed and D typing not performed has remained relatively unchanged (5%). The frequencies of anti‐D and anti‐‘Mia’ among 38 537 patients who were transfused at MMH during 2008–2017 were found to be 0·06% and 2·6%, respectively. During the same period, among 3 510 131 blood donors at Taiwan Blood Foundation, the frequencies of anti‐D and anti‐‘Mia’ were 0·004% and 0·2%, respectively.ConclusionThe elimination of D typing of patients at MMH has proven to have been a correct and logical decision. D‐ patients, if they do not carry anti‐D, can thus be safely transfused with D+ red cells.