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Monoclonal anti‐D specificity and Rh D structure: criteria for selection of monoclonal anti‐D reagents for routine typing of patients and donors
Author(s) -
Jones J.,
Scott M. L.,
Voak D.
Publication year - 1995
Publication title -
transfusion medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.471
H-Index - 59
eISSN - 1365-3148
pISSN - 0958-7578
DOI - 10.1111/j.1365-3148.1995.tb00225.x
Subject(s) - typing , monoclonal antibody , abo blood group system , monoclonal , polyclonal antibodies , blood typing , medicine , transfusion medicine , rh blood group system , antigen , blood transfusion , immunology , biology , antibody , genetics
SUMMARY. The Rh blood group system is the next most important to the ABO system in terms of its clinical significance in blood transfusion. It is vital to the safe, efficient practice of transfusion medicine that Rh D phenotyping tests are selected, executed and interpreted correctly. However, the Rh D blood group antigen has been shown to be subject to many phenotypic variations, and different reagents and typing techniques vary in their ability to detect these variants. The range of D‐positive phenotypes are reviewed in terms of their reactivity with monoclonal antibody reagents and their clinical significance. In view of the available evidence, it is suggested that patient typing can be safely achieved by the duplicate use of one high‐avidity or two very similar IgM monoclonal anti‐D reagents that detect most variants except category D VI in simple tube or microplate saline tests. Antiglobulin testing for weak D should not be carried out on patient samples. Donor typing can be safely achieved by the use of the same monoclonal, used in parallel with a polyclonal anti‐D reagent that detects D VI on sensitive automated equipment.