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Weak or partial D: Importance of molecular characterization of D variants.

Transfus Apher Sci

January 2025

ICMR-National Institute of Immunohaematology (NIIH), 13th Floor, K.E.M Hospital campus, Parel, Mumbai 400012, India. Electronic address:

This case report presents first case of RHD*weak D type 9 in a 38-year-old Indian patient with severe osteoarthritis of the left hip joint scheduled for total hip replacement surgery. During routine blood grouping, an unexpected weak reaction with anti-D was observed. Serological characterization using an extended partial D typing kit characterized the variant as DV.

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Background and objective RhD variants show altered D antigen expression, affecting their serological detection. Proper identification is crucial due to potential anti-D antibody formation. This study aimed to retrospectively analyze the frequency and characteristics of D variant cases encountered during RhD typing in both blood donors and recipients and the transfusion implications.

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Objective: The objective of this study was to rigorously investigate and elucidate the genetic mechanisms underlying the formation of the RH blood group in a specific case and to systematically analyse the RH blood group genes among the family members of the proband.

Methods: Serological methods were used to determine the RH blood group phenotype of the proband. To elucidate the underlying genetic mechanism responsible for the RH phenotype, a comprehensive approach was undertaken, including RHCE genotyping, sequencing of RHD and RHCE genes, and exon sequencing of RHAG.

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[Study on the Production of Anti-D and Anti-E Mixed Antibodies by Alloimmunization in RhD Variant Type33 Recipients].

Zhongguo Shi Yan Xue Ye Xue Za Zhi

December 2024

Blood Group Reference Laboratory, Ningxia Blood Center, Yinchuan 750000, Ningxia Hui Autonomous Region, China.

Objective: To investigate the cause of the production of anti-D and anti-E mixed antibody in an RhD positive patient.

Methods: The ABO/Rh blood group typing and irregular antibody specificity were identified by conventional serological methods, the gene exon 1-10 and heterozygous analysis were performed by sequence-specific primer polymerase chain reaction (PCR-SSP), and the whole exon sequence was analyzed by first-generation sequencing.

Results: The patient's Rh blood group was weak D Type33, with the allele was , the patients was found to be heterozygous, with an Rh typing of Ccee, and the patient had developed anti-D combined with anti-E mixed antibodies.

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Variant D antigens can cause variable serologic results when typing with Anti-D reagents. There is limited information regarding the ability of Anti-D reagents to differentiate between D variants defined by genotyping. This study was performed to determine if a panel of 20 U.

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