Abstract
The aim of this study was to search for the partial D phenotype in Moroccan blood donors with weak D expression. The study included 32 samples with weak D phenotype, and partial D category red blood cells were detected with the D-Screen Diagast kit, which consists in 9 monoclonal anti-D antibodies specific for the most common categories of partial D. Among the 32 samples studied, we identified 13 specific reactions to a partial D antigen (3 DVI, 2 DVa, 2 DIII(a,b,c), and 6 DVII), with 8 reactions suggesting a weak D and 11 reactions providing no formal argument in favor of a partial D antigen. This work can be used to validate the performance of the anti-D reagent and to improve the safety of transfusion of red blood cells from donors expressing the partial D antigen by integrating the finding into the recipient file with a recommendation concerning the appropriate care.
Highlights
Rhesus is one of the most important and clinically significant blood group systems
The study included 32 samples with weak D phenotype, and partial D category red blood cells were detected with the D-Screen Diagast kit, which consists in 9 monoclonal anti-D antibodies specific for the most common categories of partial D
This work can be used to validate the performance of the anti-D reagent and to improve the safety of transfusion of red blood cells from donors expressing the partial D antigen by integrating the finding into the recipient file with a recommendation concerning the appropriate care
Summary
Rhesus is one of the most important and clinically significant blood group systems. D antigen (ISBT 004.001; RH1) is the most immunogenic and clinically important of this system because of the ability of anti-D to cause transfusion reactions and hemolytic disease of the foetus and newborn. Partial D variants lack one or more epitopes of D antigen while weak D variants have all epitopes present but express a significantly reduced amount of D antigen per red blood cell and are usually identified by the indirect antiglobulin test (IAT). Individuals whose red blood cells do not carry all the parts of the D mosaic can, when exposed to the full D antigen, produce anti-D alloantibodies directed against one or more of the missing epitopes, defining the phenotype “partial D.”. It is very important to identify a donor having a D variant (weak D or D partial D) since in some instances these red blood cells can trigger an immune response if transfused to a recipient who is D negative
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