RHD variants in Flanders, Belgium

Abstract

Despite the enormous diversity of RHD alleles, first-line weak D genotyping was remarkably informative, allowing for rapid classification of most samples with conspicuous RhD phenotype in Flanders. The clinical implications are discussed.

Diverse and novel RHD variants in Australian blood donors with a weak D phenotype: implication for transfusion management

“…The distribution of RHD variants associated with the weak D phenotype is population dependent. Weak D types 1, 2 and 3 are most frequent in European and Canadian populations [6,8,10,[18][19][20]. Weak D types 4Á0 and 4Á1 have been reported as frequently occurring alleles in African populations from Egypt, Tunisia, Ethiopia and South Africa [7,21,22].…”

Frequency and characterization of known and novel RHD variant alleles in 37 782 Dutch D‐negative pregnant women

“…Interestingly, the RHD*721A>C allele was detected in seven cases whereas all other novel alleles, except the RHD*1074‐1G>A allele, were detected in single cases. This allele was not detected in previous studies performed in Germany, Austria, Poland and Belgium, respectively (Flegel et al , ; Polin et al , ; Orzinska et al , ; Van Sandt et al , , respectively, indicating that this allele is specific for the Dutch population. All women positive for the RHD*721A>C allele had Dutch surnames but we have no indication that these women are related.…”

It's time to phase out “serologic weak D phenotype” and resolve D types with RHD genotyping including weak D type 4

“…3 Use of two different serologic methods or anti-D reagents have been shown to be an effective practice for identifying those patients who will benefit from RHD genotyping. 28,29,39,40,[44][45][46][47][48] Our interpretations of RHD genotype results are summarized in a crosswalk table of RHD allele assignments (Table 1) to standardize reporting and guidance to manage as D+, D−, or uncommonly as indeterminate risk. Indeed, AABBaccredited immunohematology reference laboratories are already required to provide recommendations for RhIG administration and selection of the most compatible RBCs for transfusion.…”