Case report
Rh is a complex blood group system with diverse genotypes that may encode weak and partial D variants. Standard serologic analysis may identify clinically significant D variants as D+; nevertheless, individuals with these D variants should be managed as D– patients to prevent antibody formation to absent D epitopes. Variant identification is necessary during pregnancy to allow for timely and appropriate Rh immune globulin (RhIG) prophylaxis for hemolytic disease of the fetus and newborn
Jennifer A. Duncan,
Susan Nahirniak,
Rodrigo Onell,
Gwen Clarke
Immunohematology , ISSUE 2, 60–63
Article
Individuals whose RBCs are characterized as having a partial D phenotype may make anti-D if exposed to normal D+ RBCs;thus it is desirable that they be typed as D– should they require blood transfusion or Rh immune globulin (RhIG) prophylaxis. Further, use of different anti-D reagents by blood centers and transfusion services can account for FDA-reportable errors. For this study,antiD reagents for use in tube tests were obtained from three U.S. manufacturers. They included three examples
W. John Judd,
Marilyn Moulds,
Gloria Schlanser
Immunohematology , ISSUE 4, 146–148
Article
the Ortho ProVue results alone, 65 percent of these individuals would have been classified as D+ and no RhIG would have been administered when, in fact, they were partial D. Furthermore, this study demonstrates the advantage of using an alternate method such as tube testing to obtain the required second ABO/D type of a patient before transfusion and for purposes of determining RhIG prophylaxis. In more than half of the cases with discordant results between gel and tube testing, partial D alleles
T.N. Horn,
J. Keller,
M.A. Keller,
L. Klinger
Immunohematology , ISSUE 4, 146–151
Report
Despite the existence of long-standing, well-organized programs for Rh immune globulin (RhIG) prophylaxis, immune anti-D continues to be detected in the D– perinatal population. Between 2006 and 2008, 91 prenatal patients, found to have a previously unidentified anti-D, were followed up with a survey to their treating physician and with additional serologic testing where possible. The physician survey requested pregnancy and RhIG history information, including recent or distant potential
Judith L. Hannon,
Gwen Clarke
Immunohematology , ISSUE 3, 108–111
Article
Failures of Rh immune globulin (RhIG) prophylaxis occur when the dose is too small. We report a test using a gel technology (GT) method to replace the Kleihauer–Betke (K–B) test to assess fetomaternal hemorrhage (FMH) and assist in determining the minimum necessary dose of RhIG. Cord blood (O, D+) was mixed with adult blood (O D–) to mimic an FMH of 10 mL, 20 mL, 28 mL, and 40 mL. Test samples were incubated with anti-D at known concentrations and centrifuged. The supernatant
John R. Fernandes,
Ronny Chan,
Ahmed S. Coovadia,
Marciano D. Reis,
Peter H. Pinkerton
Immunohematology , ISSUE 3, 115–119
Report
More than 50 red blood cell (RBC) alloantibodies are known to cause hemolytic disease of the fetus and newborn (HDFN). Although Rh immune globulin (RhIG) prophylaxis has significantly reduced the incidence of pregnancies complicated by anti-D, the need to detect and monitor maternal alloantibodies capable of causing HDFN is still a concern. The prevalence and specificity of these alloantibodies were determined. In this retrospective study, the prevalence and specificities of unexpected RBC
Heather M. Smith,
Rosetta S. Shirey,
Sandra K. Thoman,
Jay B. Jackson
Immunohematology , ISSUE 4, 127–130