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Rh(D) Immunoglobulin – Where Does it Come From?
Author(s) -
Davison Tanya,
Wylie Brenton
Publication year - 2005
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.1365-3148.2005.00554aa.x
Subject(s) - antibody , medicine , rh blood group system , immunoglobulin g , gestation , pregnancy , obstetrics , immunology , biology , genetics
Australian Rh(D) Immunoglobulin is produced by CSL Bioplasma using plasma containing anti‐D collected by the Australian Red Cross Blood Service (ARCBS) from Australian voluntary blood donors. The ARCBS Rh Project was established, initially in New South Wales in 1967, with an aim of providing an adequate supply of Australian derived Rh(D) Immunoglobulin. In 1999, the NHMRC ‘Guidelines on the prophylactic use of Rh(D) Immunoglobulin (Anti‐D) in obstetrics’ stated that universal prophylaxis with Rh(D) Immunoglobulin to RhD negative women with no preformed anti‐D antibodies at 28 and 34 weeks gestation is generally regarded as best practice. With the availablity of Rh(D) Immunoglobulin at that time, the NHMRC recommended a phased implementation commencing with all Rh(D) negative primigravidae with no preformed anti‐D antibodies (Phase 1). Phase 1 commenced in late 2002. The NHMRC recommemnded that full antenatal prophylaxis (phase 2) would be implemented when domestic supplies of Rh(D) Immunoglobulin increased sufficiently to cover the increased demand. The ARCBS plays an integral part in the implementation of universal antenatal prophylaxis by being the supplier of plasma containing anti‐D for production and as the distributor of the final Rh(D) Immunoglobulin product. In 1999, the ARCBS supplied an average of 15 × 106 IU of anti‐D per month to CSL Bioplasma. Implementation of phase 1 occurred following the introduction of two new products; the Australian derived Rh(D) Immunoglobulin 250 IU dose for first trimester indications and the temporary importation of WinRho SDFTM for postnatal use. Implementation of phase 2 and 3 requires the ARCBS to increase the amount of anti‐D collected to an average of 30 × 106 IU and 45 × 106 IU per month, respectively. Phase 3 of the program is full antenatal prophylaxis supported entirely by domestic product. In 2002, additional funding was allocated to the ARCBS Rh Project to implement strategies to ensure that the input targets for phase 2 and 3 are achieved. In mid 2004, following months of primary immunisation and boosting of both new and existing donors, input levels began to consistently meet or exceed 30 × 106 IU, and planning for phase 2, implementation began. This presentation will give an overview of the strategies used by the ARCBS to increase the volume of anti‐D collected from these donors.