RhD alloimmunization by DEL variant missed in donor testing

• DOI: 10.1111/trf.16862
• Publication Date: 2022-03-23T07:04:32Z
• Authors: Hana Safic Stanic; Vesna Dogic; Jasna Bingulac‐Po...; Zrinka Kruhonja G...; Miljana Stojic Vi...; Kresimir Puljic; Irena Jukic
• Keywords: Rh-Hr Blood-Group System; Genotype; Blood Donors; DNA; 3. Good health; 03 medical and health sciences; Phenotype; 0302 clinical medicine; Isoantibodies; Blood Group Antigens; Humans; Alleles

Abstract Introduction Exposure to normal or variably expressed RhD antigens in an antigen‐negative individual can elicit immune response and lead the formation of clinically significant anti‐D alloantibodies. We present case alloimmunization by DEL variant missed routine blood donor screening. Material Methods Blood donors were typed for D antigen using direct serologic micromethod. Nonreactive samples confirmed indirect antiglobulin method with IgM/IgG monoclonal reagent. Genomic DNA was extracted a commercial QIAamp Mini kit on QIAcube device (Qiaqen, Germany). RHD genotyping performed PCR‐SSP kits‐ Ready Gene weak, weak screen, CDE, AddOn (Inno‐Train, Unidentified alleles sent genome sequencing. Results After identifying positive units negative pool, look‐back study determine if their previous donations caused recipients. Out 40 recipients, one developed alloantibody after 45 days. The patient did not receive other products. agglutination method. screening positive, but sequencing showed no mutation indicating genotype. Conclusion Currently used methods are insufficient identify many alleles, especially intronic variations. suggest additional gene investigation including yet unexplored regions regulation intron justify our serological finding.