Weak and Variant RhD Antigens – Characteristics and
Frequency of Types Investigated in 1997–2002 in the Reference Laboratory for Immunohaematology
Písačka M., Vytisková J., Zavadil J., Karasová R., Králová M., Prosická M., Flídrová H., Flegel W. A., Wagner F. F.
Ústav hematologie a krevní transfuze, Praha |
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Summary:
RhD antigen is the main antigen of the Rh system and belongs to the clinically most relevant antigens
of the human red cell. Correct determination of the RhD status is important for the prevention of
haemolytic transfusion reactions and for prevention and treatment of the haemolytic disease of the
newborn. Numerous atypical forms of RhD protein (D variants = qualitative changes; weak D =
quantitative changes) complicate RhD assessment. Knowledge of the frequency of variant and weak D
types in the population is helpful for the choice of optimal anti-D reagents and for transfusion and
immunoprophylactic recommendations. The authors present the first extensive study of atypical D
antigens in the Czech population.Most frequent variants detected were D VI (10x), DFR (7x) and D VII
(6x), relatively frequent (3x) was DCS variant, which was so far detected only in the local population.
In our study we detected also DIVb and rare variants DOL and DYO. Alloimmunization was detected
in patients with variants D IIIc, D VII and DNB. In carriers atypical D antigen in Rh phenotype R1r the
frequency of D variants was cca 7% while in Rh phenotype R2r was five times more frequent – Rh
phenotype could serve as a guide for safer substitution and prophylaxis before definitive assessment
of the D weak or variant type. Possibilities and limits of use of commercial kits for D pheno- and
genotyping in the Czech population are discussed.
Key words:
RhD antigen, variant D antigens, weak D antigens, frequency, detection by monoclonal
antibodies and PCR-SSP
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