Monoclonal anti-D specificity and Rh D structure: criteria for selection of monoclonal anti-D reagents for routine typing of patients and donors

Transfus Med. 1995 Sep;5(3):171-84. doi: 10.1111/j.1365-3148.1995.tb00225.x.


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 DVI 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 DVI on sensitive automated equipment.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal / immunology*
  • Antibody Specificity*
  • Blood Donors
  • Blood Grouping and Crossmatching*
  • Epitopes / chemistry
  • Epitopes / immunology
  • Female
  • Fetal Blood
  • Humans
  • Indicators and Reagents
  • Phenotype
  • Pregnancy
  • Rh-Hr Blood-Group System / chemistry*
  • Rh-Hr Blood-Group System / immunology*


  • Antibodies, Monoclonal
  • Epitopes
  • Indicators and Reagents
  • Rh-Hr Blood-Group System