Weak D phenotypes and transfusion safety: where do we stand in daily practice?

Abstract

Serology is very sensitive to detect weak D Types 1, 2, and 3, but there is no cutoff to distinguish variants of clinical significance. When molecular analysis is not available, it is proposed that a D+ status for blood recipients found to be weak D with a sensitive method be assigned, except for women of childbearing age or younger, because of the remaining possibility to be partial D or other rare weak D who can be immunized.

Characterization of anti‐D monoclonal antibody reagents based on their reactivity with the weak D phenotype

“…This can lead to errors in D typing in both patients and donors. The use of different technologies for blood typing can complicate this problem 13‐19 . In this report, we studied the similarities between the reactivity of different anti‐D MoAbs and the weak D phenotype.…”

“…Additionally, differences in the various antibodies' reactivity must be considered in relationship with the technologies used for blood typing 13‐17 . Difficulties in D typing could be overcome by the routine use of molecular biology.…”

Variants of RhD – current testing and clinical consequences

“…If, however, only serological testing is being used, this policy is difficult to apply because identification of variants is often not possible. Noizat‐Pirenne et al () observed a range of reactivity for weak D of the same type, tested with the same reagent by a gel matrix technique.…”

On the trail of anti‐CDE to unexpected highlights of the RHD*weak 4.3 allele in the Upper Austrian population

“…In two samples with D+C‐c+E+e+ phenotype, a suppressed expression of the e antigen on RBCs was noted. This altered expression was identified before when associated with C X [19, 24] but also with Cys16 and VS [3, 19]. In the other samples with the e‐specific nucleotides in homozygous occurrence, a depressed expression of e S was not detected, explainable by masking of the aberrant haplotype by the conventional Rhe encoded on the partner chromosome.…”