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Practice Guideline
. 2015 Mar;55(3):680-9.
doi: 10.1111/trf.12941. Epub 2014 Dec 1.

It's time to phase in RHD genotyping for patients with a serologic weak D phenotype. College of American Pathologists Transfusion Medicine Resource Committee Work Group

S Gerald Sandler  1 , Willy A Flegel, Connie M Westhoff, Gregory A Denomme, Meghan Delaney, Margaret A Keller, Susan T Johnson, Louis Katz, John T Queenan, Ralph R Vassallo, Clayton D Simon; College of American Pathologists Transfusion Medicine Resource Committee Work Group
Affiliations
Practice Guideline

It's time to phase in RHD genotyping for patients with a serologic weak D phenotype. College of American Pathologists Transfusion Medicine Resource Committee Work Group

S Gerald Sandler et al. Transfusion. 2015 Mar.
No abstract available

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Conflict of interest statement

Conflict of interest:

WAF receives royalties for RHD genotyping. GAD is named as an inventor of granted red cell genotyping European Patents Serial No. 2298784 and 2298785, currently owned by Canadian Blood Services. MAK receives financial support from Life Technologies for genotyping software development consulting, has received research support from BioArray and has been on Immucor’s speakers bureau. RV receives research support from Fenwal. SGS, CMW, MD, STJ, LK, JTQ and CDS have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Unnecessary RhIG Injections. Of 3,953,000 live births in the United States each year, an estimated 13,360 mothers have a serological weak D phenotype which, if confirmed by RHD genotyping, could be managed as RhD-positive. Adjusting for antepartum and postpartum dosing, RHD genotyping of pregnant women with a serological weak D phenotype could prevent 24,700 unnecessary injections of RhIG.
Fig. 2
Fig. 2
Unnecessary Transfusion of RhD-negative RBC Units. Of 5,000,000 individuals transfused annually in the United States, an estimated 17,520 with a serological weak D phenotype will, in the absence of indirect antiglobulin testing, be typed as RhD-negative. If their RHD genotype were determined, they could be managed safely as RhD-positive. Since the average number of RBC units is 2.7 per recipient, RHD genotyping could make 47,700 units of RhD-negative RBCs available to patients who require them.
Fig. 3
Fig. 3
Algorithm for resolving serological weak D phenotype test results by RHD genotyping to determine candidacy for Rh immune globulin (RhIG) and RhD type for transfusions.
See this image and copyright information in PMC

References

Background

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