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PLASTIC RECONSTRUCTIVE AND REGENERATIVE SURGERY

Abstract

Background - In the Rhesus (Rh) blood group system, D is the most immunogenic antigen. RhD-negative patients with anti-D must be transfused RhD-negative red blood cells (RBC) to avoid hemolytic transfusion. RBC of  Asian-type DEL phenotype are typed as RhD-negative by routine blood group serological methods because they have very weak expression of D antigen. The prevalence of  Asian-type DEL phenotypes was 30% in RhD-negative Chinese donors. Therefore, this DEL type can be transfused to RhD-negative patients with anti-D. However, there is a lack of direct evidence regarding the safety of this practice and potential mechanisms in act.

Materials and methods - The proportion of  Asian-type DEL donors that serologically tested RhD-negative was investigated by using genotyping. Furthermore, a model system for in vivo clearance was established to assess antibody-mediated phagocytosis of  Asian-type DEL RBC by macrophages.

Results - We identified six serologically RhD-negative donors, 16  Asian-type DEL donors according to polymerase chain reaction polymerase chain reaction with sequence-specific primers (PCR-SSP), and six PCR-SSP
RhD-positive donors across various regions in China. Our study revealed that
antibody-mediated RBC clearance was not observed following co-culture of opsonized  Asian-type DEL RBC with macrophages.

Discussion - Incompatible transfusion of  Asian-type DEL RBC may not result in significant RBC clearance.

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Authors

Qi Ren Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sci-ences and Peking Union Medical College, Chengdu, Sichuan Province, China; Key Laboratory of Transfu-sion Adverse Reactions, CAMS, Chengdu, Sichuan Province, China; Zhongshan Central Blood Station, Zhongshan, Guangdong Province, China

Tong Li Department of Neurosurgery, Pengzhou Second People’s Hospital, Chengdu, Sichuan Province, China

Ziyue Mi Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sci-ences and Peking Union Medical College, Chengdu, Sichuan Province, China; Key Laboratory of Transfu-sion Adverse Reactions, CAMS, Chengdu, Sichuan Province, China

Yudi Xie Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan Province, China; Key Laboratory of Transfusion Adverse Reactions, CAMS, Chengdu, Sichuan Province, China ORCID

Lushu Cao Yaan Center Blood Station, Yaan, Sichuan Province, China

Yan Xia Yaan Center Blood Station, Yaan, Sichuan Province, China

Haixia Xu Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan Province, China; Key Laboratory of Transfusion Adverse Reactions, CAMS, Chengdu, Sichuan Province, China

Honghong He Department of Blood Screening, Suzhou Blood Center, Suzhou, Jiangsu Province, China ORCID

Li Tian Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan Province, China; Key Laboratory of Transfusion Adverse Reactions, CAMS, Chengdu, Sichuan Province, China

Zhong Liu Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan Province, China; Key Laboratory of Transfusion Adverse Reactions, CAMS, Chengdu, Sichuan Province, China

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