Abstract
Background and objectives
DEL (D-elute) red blood cells (RBCs) are typed as D- by routine serological methods, as
they carry a very weak form of D variant. Asia type DEL (c.1227 G>A) is the most prevalent
DEL allele in East Asian populations that can lead to alloimmunization in D negative
transfusion recipients. This study aimed to screen D+ and D- Thai blood donors for
the Asia type DEL and its zygosity.
Materials and methods
Blood samples of 723 D+ , and 191 D- Thai blood donors were collected. D antigen was
typed by the routine serological method and adsorption-elution test to screen DEL
phenotype. The hybrid Rhesus box, RHD 1227 G, RHD 1227 A and RHD exon 4 were analyzed with polymerase chain reaction using sequence specific primers,
PCR-SSP.
Results
Among 191 D- blood donors, 52 (27.2%) RHD 1227 A allele carriers were detected, and 39 out of these 52 (75.0%) were positive
for the hybrid Rhesus box (i.e. hemizygous RHD 1227 A). The remaining carriers were RHD 1227 A homozygous. RHD zygosity analysis in Thai D+ blood donors showed that only 4% (29/723) had a Dd genotype (hemizygous RHD 1227 G). Five (0.69%) blood donors were detected with RHD 1227 A alleles among 723 D+ blood donors. They were all G/A heterozygous at the RHD 1227 site.
Conclusion
This study indicates that the high prevalence of RHD 1227 A allele among serologically apparent D- blood donors in Thais. Furthermore,
the screening of hybrid Rhesus box, RHD 1227 A combined with RHD exon 4 is useful for analyses of Asia type DEL and its zygosity.
Keywords
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References
file:///C:/Users/User/Downloads/Tableofbloodgroupsystemsv10030-JUN-2021withLRGandrevisedantigens%20(5).pdf. accessed on 30th June 2021.
- Molecular background of Rh D-positive, D-negative, D(el) and weak D phenotypes in Chinese.Vox Sang. 2002; 83: 156-161
- RHD gene deletion occurred in the Rhesus box.Blood. 2000; 95: 3662-3668
- RHD allele distribution in Africans of Mali.BMC Genet. 2003; 4: 14
- Molecular characterization of D- Korean persons: development of a diagnostic strategy.Transfusion. 2005; 45: 345-352
- An effective diagnostic strategy for accurate detection of RhD variants including Asian DEL type in apparently RhD-negative blood donors in Korea.Vox Sang. 2016; 111: 425-430
- The presence of an RHD pseudogene containing a 37 base pair duplication and a nonsense mutation in africans with the Rh D-negative blood group phenotype.Blood. 2000; 95: 12-18
- Molecular genetics and clinical applications for RH.Transfus Apher Sci. 2011; 44: 81-91
- Variants of RhD--current testing and clinical consequences.Br J Haematol. 2013; 161: 461-470
- The molecular genetics of blood group polymorphism.Hum Genet. 2009; 126: 729-742
- Blood groups in Thai blood donors.Thai J Hematol Transfus Med. 2002; 12: 277-286
- Nation-wide investigation of RHD variants in Thai blood donors: Impact for molecular diagnostics.Transfusion. 2021; 61: 931-938
- DEL phenotype.Immunohematology. 2017; 33: 125-132
- A comprehensive analysis of DEL types: partial DEL individuals are prone to anti-D alloimmunization.Transfusion. 2005; 45: 1561-1567
- International Society of Blood Transfusion Working Party on Red Cell Immunogenetics and Blood Group Terminology: Report of the Dubai, Copenhagen and Toronto meetings.Vox Sang. 2019; 114: 95-102
- RhC phenotyping, adsorption/elution test, and SSP-PCR: the combined test for D-Elute phenotype screening in Thai RhD-negative blood donors.ISRN Hematol. 2012; 358316
- An easy RHD genotyping strategy for D- East Asian persons applied to Korean blood donors.Transfusion. 2006; 46: 2128-2137
- RHD genotype and zygosity analysis in the Chinese Southern Han D+, D- and D variant donors using the multiplex ligation-dependent probe amplification assay.Vox Sang. 2017; 112: 660-670
- Molecular basis of DEL phenotype in the Chinese population.BMC Med Genet. 2014; 15: 54
- Molecular basis of D variants between Uigur and Han blood donors in Xinjiang.Transfus Med. 2008; 18: 199-203
- Detection of RhD(el) in RhD-negative persons in clinical laboratory.J Lab Clin Med. 2005; 146: 321-325
- Prospective evaluation of a transfusion policy of RhD-positive red blood cells into DEL patients in China.Transfus Med Hemother. 2015; 42: 15-21
- Prevalence of RHD 1227A and hybrid Rhesus box in the general Chinese population.Transl Res. 2007; 149: 31-36
- Use of real time PCR for rapid detection of Del phenotype in Taiwan.Ann Clin Lab Sci. 2008; 38: 258-263
- RHD 1227A is an important genetic marker for RhDel individuals.Am J Clin Pathol. 2004; 122: 193-198
- Secondary anti-D immunization by Del red blood cells.Transfusion. 2005; 45: 1581-1584
- Molecular basis for D- Japanese: identification of novel DEL and D- alleles.Vox Sang. 2015; 109: 359-365
- Primary anti-D immunization by DEL red blood cells.Korean J Lab Med. 2009; 29: 361-365
- Primary anti-D alloimmunization induced by "Asian type" RHD (c.1227G>A) DEL red cell transfusion.Ann Lab Med. 2015; 35: 554-556
- DEL RBC transfusion should be avoided in particular blood recipient in East Asia due to allosensitization and ineffectiveness.J Zhejiang Univ Sci B. 2012; 13: 913-918
- HLA class I and II alleles and haplotypes in ethnic Northeast Thais.Tissue Antigens. 2010; 75: 701-711
- Sensitivity of fetal RHD screening for safe guidance of targeted anti-D immunoglobulin prophylaxis: prospective cohort study of a nationwide programme in the Netherlands.BMJ. 2016; 355: i5789
- Molecular basis and zygosity determination of D variants including identification of four novel alleles in Chinese individuals.Transfusion. 2015; 55: 137-143
- Six years’ experience performing RHD genotyping to confirm D- red blood cell units in Germany for preventing anti-D immunizations.Transfusion. 2009; 49: 465-471
- RHD positive haplotypes in D negative Europeans.BMC Genet. 2001; 2: 10
- Recommendations regarding Practical DEL Typing Strategies for Serologically D-Negative Asian Donors.Transfus Med Hemother. 2020; 47: 88-93
- Transfusion of RhD-positive blood in “Asia type” DEL recipients.New Engl J Med. 2010; 362: 472-473
Article info
Publication history
Published online: June 25, 2022
Accepted:
June 24,
2022
Received in revised form:
April 18,
2022
Received:
November 21,
2021
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
