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Serological weak D phenotypes: a review and guidance for interpreting the RhD blood type using the RHD genotype
Author(s) -
Sandler S. Gerald,
Chen Leonard N.,
Flegel Willy A.
Publication year - 2017
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.14757
Subject(s) - serology , genotype , phenotype , typing , immunology , medicine , isoantibodies , virology , antigen , antibody , biology , genetics , gene
Summary Approximately 0·2–1% of routine RhD blood typings result in a “serological weak D phenotype.” For more than 50 years, serological weak D phenotypes have been managed by policies to protect RhD‐negative women of child‐bearing potential from exposure to weak D antigens. Typically, blood donors with a serological weak D phenotype have been managed as RhD‐positive, in contrast to transfusion recipients and pregnant women, who have been managed as RhD‐negative. Most serological weak D phenotypes in Caucasians express molecularly defined weak D types 1, 2 or 3 and can be managed safely as RhD‐positive, eliminating unnecessary injections of Rh immune globulin and conserving limited supplies of RhD‐negative RBC s. If laboratories in the UK , Ireland and other European countries validated the use of potent anti‐D reagents to result in weak D types 1, 2 and 3 typing initially as RhD‐positive, such laboratory results would not require further testing. When serological weak D phenotypes are detected, laboratories should complete RhD testing by determining RHD genotypes (internally or by referral). Individuals with a serological weak D phenotype should be managed as RhD‐positive or RhD‐negative, according to their RHD genotype.