Reactivity of FDA-approved anti-D reagents with partial D red blood cells


Share / Export Citation / Email / Print / Text size:


American National Red Cross

Subject: Medical Laboratory Technology


ISSN: 0894-203X
eISSN: 1930-3955





Volume / Issue / page

Volume 37 (2021)
Volume 36 (2020)
Volume 35 (2019)
Volume 34 (2018)
Volume 33 (2017)
Volume 32 (2016)
Volume 31 (2015)
Volume 30 (2014)
Volume 29 (2013)
Volume 28 (2012)
Volume 27 (2011)
Volume 26 (2010)
Volume 25 (2009)
Volume 24 (2008)
Volume 23 (2007)
Volume 22 (2006)
Volume 21 (2005)
Volume 20 (2004)
Volume 19 (2003)
Volume 18 (2002)
Volume 17 (2001)
Volume 16 (2000)
Volume 15 (1999)
Volume 14 (1998)
Volume 13 (1997)
Volume 12 (1996)
Volume 11 (1995)
Volume 10 (1994)
Volume 9 (1993)
Volume 8 (1992)
Volume 7 (1991)
Volume 6 (1990)
Volume 5 (1989)
Volume 4 (1988)
Volume 3 (1987)
Related articles

VOLUME 21 , ISSUE 4 (December 2005) > List of articles

Reactivity of FDA-approved anti-D reagents with partial D red blood cells

W. John Judd / Marilyn Moulds / Gloria Schlanser

Keywords : anti-D reagents, partial D red blood cells, gel column technology

Citation Information : Immunohematology. Volume 21, Issue 4, Pages 146-148, DOI:

License : (Transfer of Copyright)

Published Online: 28-April-2020



Individuals whose RBCs are characterized as having a partial D phenotype may make anti-D if exposed to normal D+ RBCs;thus it is desirable that they be typed as D– should they require blood transfusion or Rh immune globulin (RhIG) prophylaxis. Further, use of different anti-D reagents by blood centers and transfusion services can account for FDA-reportable errors. For this study,antiD reagents for use in tube tests were obtained from three U.S. manufacturers. They included three examples of IgM monoclonal anti-D blended with monoclonal IgG anti-D, one IgM monoclonal anti-D blended with polyclonal IgG anti-D, and two reagents formulated with human anti-D in a high-protein diluent. One antiD formulated for use by gel column technology was also tested. Direct agglutination tests by tube or gel were strongly positive (scores 9–12), with partial D RBCs of types DII, DIIIa, DIIIb, and DIVa. No reagent anti-D caused direct agglutination of DVI type 1, DVI type 2, or DFR phenotype RBCs. One tube anti-D reagent formulated with an IgM monoclonal anti-D plus a polyclonal IgG anti-D failed to cause direct agglutination of DVa, DBT, and R0Har RBCs, while DVa RBCs reacted weakly with two high-protein reagents formulated with human IgG anti-D. In contrast,the anti-D used by gel column technology was strongly reactive (score 11) with DVa, DBT, and R0Har RBCs. The single monoclonal IgM–polyclonal IgG blended anti-D and the two high-protein reagents were also the only reagents that failed to react with R0Har RBCs by the IAT. Elimination of the test for weak D on all patient samples, using currently available FDA-licensed reagents, will ensure that partial D category VI (DVI) patients will type as D– for the purpose of RhIG prophylaxis and blood transfusion. However, RBCs of other partial D phenotypes will be classified as D+ in direct agglutination tests with some,if not all,currently available reagents. Testing donors for weak expression of D continues to be required, albeit that Rh alloimmunization by RBCs with a weak or partial D phenotype is uncommon. Further, because of differences in performance characteristics among FDA-approved reagents, conflicts between donor center D typing and transfusion service confirmatory test results are inevitable.

You don't have 'Full Text' access of this article.

Purchase Article Subscribe Journal Share