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. 2018 Mar;32(3):e22285.
doi: 10.1002/jcla.22285. Epub 2017 Jun 26.

Anti-D Reagents Should Be Chosen Accordingly to the Prevalence of D Variants in the Obstetric Population

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Free PMC article

Anti-D Reagents Should Be Chosen Accordingly to the Prevalence of D Variants in the Obstetric Population

Jelena Lukacevic Krstic et al. J Clin Lab Anal. .
Free PMC article

Abstract

Background: Resolving ambiguous results of D antigen typing is crucial for appropriate and rational administration of anti-D immunoprophylaxis and transfusion practice in obstetric population. The aim of the study was to establish selection criteria of anti-D reagents for our population.

Methods: A total of 12 689 samples from primiparous women in Split-Dalmatia County, Croatia, were typed for RhD antigen during the period of 5 years. Ambiguous results were submitted to additional serologic investigation and genotyping. RHD genotyping was performed by commercial genotyping kits (Ready Gene weak D ® and Ready gene CDE, Inno-Train, Kronberg, Germany). Relative frequencies and accompanying 95% confidence intervals were used to estimate the prevalence of variants.

Results: The prevalence of D variants was 0.42% (95% CI 0.31; 0.53). The most common partial D variant was D Va (RHD*05.05), with the prevalence of 0.08% (95% CI 0.03; 0.13). All weak D variants were weak D types 1, 2 and 3 (RHD*weak D type 1, RHD*weak D type 2, RHD*weak D type 3). Weak D samples were distinguishable from partial D in routine typing due to the difference in reactivity of partial D samples with clones D7B8 and RUM-1. Cell line RUM-1 gives weak or negative reactions with partial DVa category.

Conclusion: The most common partial D variant in our population is DVa. It is recommended to use cell lines which do not strongly agglutinate DVa variant in routine RhD typing. The appropriate choice of reagents will enable the serology methods to recognize the cases in which RHD genotyping is required.

Keywords: D variants; anti-D reagents; obstetric; population.

Figures

Figure 1
Figure 1
Algorithm of D antigen testing using microcolumn beads technology, from April 10, 2008 to December 31, 2012
Figure 2
Figure 2
Serologic reactivity of weak D (type 1) in microcolumn technology
Figure 3
Figure 3
Serologic reactivity of partial D (RHD*05.05) in microcolumn technology

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