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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 https://orcid.org/0009-0006-7048-1817

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 https://orcid.org/0000-0003-2538-0356

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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