Document Detail


Antenatal Rh prophylaxis is unnecessary for "Asia type" DEL women.
MedLine Citation:
PMID:  20961786     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: Generally Rh-negative patients need to be transfused with Rh-negative red blood cells. For pregnant women carrying Rh-positive fetus, the antenatal anti-D detection and Rh immunoglobulin prophylaxis are required worldwide. In East Asia, a RhD variant, termed "Asia type" DEL, was found in approximately 30% of apparent Rh-negative individuals. The antigenic and molecular properties of the DEL were previously defined. Few data discuss whether DEL could be immunized by D antigen clinically although DEL was reported arousing alloimmunization to true Rh-negative patients.
STUDY DESIGN AND METHODS: To determine whether the DEL variant can be immunized to the D antigen, we retrospectively evaluated 104 Rh-negative pregnancies with allo-anti-D antibodies, and we also tracked 199 consecutive apparent Rh-negative pregnant women, with a history of gestations or parturitions but not subject to anti-D gamma-globulin prophylaxis, for evidence of allo-anti-D. The DEL variant was first excluded by ccee phenotypes and then identified through PCR analysis or sequencing.
RESULTS: In the retrospective study, we expected to find 30 DEL variants, yet none of the anti-D alloimmunized women were DEL-positive. And in the second group, none of 44 DEL-positive women versus 38 of 155 (24.5%) true Rh-negative women (those excluding DEL) formed allo-anti-D.
CONCLUSION: The data indicate that the "Asia type" DEL variant does not appear at risk of alloimmunization to the D antigen. It strongly suggests that the antenatal Rh immune globulin prophylaxis is unnecessary for DEL women. Furthermore, it implicates that the "Asia type" DEL may be deemed Rh-positive safely for clinical transfusion therapy.
Authors:
Chao-Peng Shao; Hua Xu; Qun Xu; Guo-Dong Sun; Jian-Ping Li; Bo-Wei Zhang; Xiao-Hua Liang; Zhong Liu; Ying Zhou; Dan Li; Nai-Bao Zhuang
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-10-18
Journal Detail:
Title:  Transfusion clinique et biologique : journal de la Société française de transfusion sanguine     Volume:  17     ISSN:  1953-8022     ISO Abbreviation:  Transfus Clin Biol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-11-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423846     Medline TA:  Transfus Clin Biol     Country:  France    
Other Details:
Languages:  eng     Pagination:  260-4     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Masson SAS. All rights reserved.
Affiliation:
Shenzhen Institute of Transfusion Medicine, Shenzhen Blood Center, Meigang Street, Nigang West Road, Futian, Shenzhen 518035, China. cpshaos@hotmail.com
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