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CLC number: R457.1

On-line Access: 2012-11-05

Received: 2011-11-17

Revision Accepted: 2012-04-14

Crosschecked: 2012-09-27

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Journal of Zhejiang University SCIENCE B 2012 Vol.13 No.11 P.913-918

http://doi.org/10.1631/jzus.B1100348


DEL RBC transfusion should be avoided in particular blood recipient in East Asia due to allosensitization and ineffectiveness


Author(s):  Chao-peng Shao, Bao-yan Wang, Shi-hui Ye, Wen-li Zhang, Hua Xu, Nai-bao Zhuang, Xiao-ying Wu, Heng-gui Xu

Affiliation(s):  Shenzhen Blood Center, Shenzhen 518035, China; more

Corresponding email(s):   drxuhua@gmail.com

Key Words:  Rh blood group, DEL, Allo-anti-D, Transfusion, Pregnancy, Delayed hemolytic transfusion reaction


Chao-peng Shao, Bao-yan Wang, Shi-hui Ye, Wen-li Zhang, Hua Xu, Nai-bao Zhuang, Xiao-ying Wu, Heng-gui Xu. DEL RBC transfusion should be avoided in particular blood recipient in East Asia due to allosensitization and ineffectiveness[J]. Journal of Zhejiang University Science B, 2012, 13(11): 913-918.

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author="Chao-peng Shao, Bao-yan Wang, Shi-hui Ye, Wen-li Zhang, Hua Xu, Nai-bao Zhuang, Xiao-ying Wu, Heng-gui Xu",
journal="Journal of Zhejiang University Science B",
volume="13",
number="11",
pages="913-918",
year="2012",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B1100348"
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%T DEL RBC transfusion should be avoided in particular blood recipient in East Asia due to allosensitization and ineffectiveness
%A Chao-peng Shao
%A Bao-yan Wang
%A Shi-hui Ye
%A Wen-li Zhang
%A Hua Xu
%A Nai-bao Zhuang
%A Xiao-ying Wu
%A Heng-gui Xu
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%@ 1673-1581
%D 2012
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1100348

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T1 - DEL RBC transfusion should be avoided in particular blood recipient in East Asia due to allosensitization and ineffectiveness
A1 - Chao-peng Shao
A1 - Bao-yan Wang
A1 - Shi-hui Ye
A1 - Wen-li Zhang
A1 - Hua Xu
A1 - Nai-bao Zhuang
A1 - Xiao-ying Wu
A1 - Heng-gui Xu
J0 - Journal of Zhejiang University Science B
VL - 13
IS - 11
SP - 913
EP - 918
%@ 1673-1581
Y1 - 2012
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B1100348


Abstract: 
Previously, both primary and secondary anti-D alloimmunizations induced by “Asian type” DEL (RHD1227A allele) were observed in two incidents. We investigated how often these alloimmunization events occur. The transfusions of any D-negative patients were investigated in the First Affiliated Hospital of Xi’an Jiaotong University Medical College, China, during the entire 2009. The antigens of D, C, c, E, and e were routinely serotyped. The “Asian type” DEL variant was genotyped and the RHD heterozygote was determined through two published methods. The changes in anti-D levels were monitored by the indirect antiglobulin test (IAT) and flow cytometry. Thirty D-negative transfused patients were included in the study. We focused on 11 recipients who were transfused with packed red blood cells (RBCs) from DEL donors at least one time. Of those 11 recipients, seven were anti-D negative before transfusion and four were anti-D positive (one patient with an autoantibody). One of the seven pre-transfusion anti-D negative patients produced a primary-response anti-D after being transfused with 400 ml of DEL blood twice. All four pre-transfusion antibody positive patients were not observed hemoglobin (Hb) levels increased, as expected after transfusions. Two patients had an increase in anti-D from 1:8 to 1:64 by IAT, which was also shown by flow cytometry. None of the patients experienced an acute hemolytic episode. Our data indicated that the primary anti-D induced by DEL transfusion or the secondary anti-D elevated by DEL in a truly D-negative patient might not be unusual. We suggest that a truly D-negative childbearing-aged woman should avoid DEL transfusion to protect her from primary anti-D allosensitization. In addition, anti-D positive recipients should also avoid DEL red cell transfusion due to the DELayed hemolytic transfusion reaction (DHTR).

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

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