RhD variants in Caucasians: consequences for checking clinically relevant alleles

BACKGROUND: Weak D type carriers cannot be immunized against D except when antigen density is below 400 antigens per RBC, whereas partial D carriers can produce anti-D. STUDY DESIGN AND METHODS: A total of 168 blood samples from Caucasian individuals were studied because of weak D expression and/or anti-D production. Serologic analysis and molecular analysis were performed. RESULTS: In total, 70 partial D and 62 weak D were identified. Among weak D samples, 30 weak D Type 1 and 21 weak D Type 2 alleles were found. Five new alleles were characterized carrying 399G > T 680T > C, 833G > A, 851 C > T, and 1015G > A, respectively. According to previous studies, antigen density was up to 500 for weak D Type 1 and 2, except when there was a dCe haplotype in trans. Antigen density was below 400 antigens per red blood cell for the new variants and most other weak D variants. CONCLUSION: These results provide molecular characterization of five new D variants. They also suggest that it would be advantageous to develop in routine laboratories weak D Type 1 and 2 genotyping for serologically depressed D antigen. It will help to avoid wasting of D-red blood cell units because carriers may safely receive D+ units.