High frequency of variant RHD genotypes among donors and patients of mixed origin with serologic weak-D phenotype

J Clin Lab Anal. 2018 Nov;32(9):e22596. doi: 10.1002/jcla.22596. Epub 2018 Jun 26.

Abstract

Background: The current transfusion policy recommended for individuals with serologic weak-D phenotype is based on data derived from European-descent populations. Data referring to the distribution of RH alleles underlying weak-D phenotype among people of mixed origin are yet incomplete, and the applicability of European-based transfusion guidelines to this specific population is questionable.

Goal: To evaluate the distribution of RHD variant genotype among individuals with serologic weak-D phenotype of both African and European descent.

Methods: Donors and patients of mixed origin and with serologic weak-D phenotype were selected for the study. They were investigated using conventional RHD-PCR assays and RHD whole-coding region direct sequencing.

Results: One hundred and six donors and 58 patients were included. There were 47 donors and 29 patients with partial-D genotype (47/106, 44.3%, and 29/58, 50%, respectively). RHD*DAR and RHD*weak D type 38 represented the most common altered RHD alleles among donors (joint frequency of 39.6%), while weak D types 1-3 accounted for 10.4% of the total D variant samples. RHD*DAR was the most common allele identified in the patient group (frequency of 31%), and weak D types 1-3 represented 29.3% of the total.

Conclusion: The frequency of partial D among mixed individuals with serologic weak-D phenotype is high. They should be managed as D-negative patients until molecular tests are complete.

Keywords: alloimmunization; donors; mixed population; partial D; weak D.

MeSH terms

  • Alleles
  • Blood Donors*
  • Blood Transfusion
  • Female
  • Gene Frequency
  • Genotype
  • Humans
  • Male
  • Phenotype
  • Polymorphism, Single Nucleotide / genetics*
  • Retrospective Studies
  • Rh-Hr Blood-Group System / genetics*
  • Rho(D) Immune Globulin / blood
  • Rho(D) Immune Globulin / genetics*
  • White People

Substances

  • Rh-Hr Blood-Group System
  • Rho(D) Immune Globulin