Blood Donation Research Today is a free monthly online journal that collates and summarizes the latest research about Blood Donation, including details on blood types, blood group, leukemia, red cross.

How I manage donors and patients with a weak D phenotype.

Flegel WA

Institute for Clinical Transfusion Medicine and Immunogenetics, Ulm, Germany. willy.flegel@uni-ulm.de

PURPOSE OF REVIEW: Since the adoption of molecular blood-group typing, the considerable heterogeneity of the serologic entities weak D and DEL at the molecular level has come to light. I offer an approach to the management of donors and patients expressing D antigen weakly and carrying any of the various molecular types of weak D and DEL. RECENT FINDINGS: More than 50 distinct weak D alleles have been described. An internet-based survey of anti-D immunizations occurring in D-positive transfusion recipients reveals that no allo-anti-D has been observed in patients carrying prevalent weak D types. Allo-immunizations are documented for weak D types 4.2 (also known as DAR), 11 and 15. Anti-D immunizations have been reported in D-negative persons transfused with weak D and DEL red blood cells. SUMMARY: Patients carrying any of the prevalent weak D types 1, 2, 3 or 4.1 are not prone to allo-anti-D immunization and may safely be transfused with D-positive red blood cells. Pregnant women with these weak D types need not receive RhIg. We should pay attention to weak D- or DEL-positive blood units that are labelled D-negative. The clinical benefit of removing DEL blood units from our supply of D-negative red blood cell units should be determined.

Published 20 October 2006 in Curr Opin Hematol, 13(6): 476-83.
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