DEL prevalence has been well characterised for most large world populations, and DEL is encountered in some patients and blood donors. They appear Rh-negative on routine blood group serology, although they are Rh-positive. Their DEL phenotype has many known molecular causes. The DEL prevalence varies greatly: 1 in 5 for China among individuals who are Rh-negative by routine serology, but only 1 in 500 for the US and EU. DEL red cells can boost pre-existing anti-D in transfusion recipients. Patients with certain DEL variants can develop anti-D, but patients with the Asian type DEL do not receive RhIg during pregnancy in China and could be transfused Rh-positive. We propose to evaluate cost benefit studies for donor typing, given that a molecular DEL screen could replace some serology testing. Safer procedures for the same or lower costs than current serology should be embraced, regardless of how safe current serology might be perceived. [ … ]



Willy Albert Flegel - Department of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, United States of America

Franz Friedrich Wagner - Red Cross Blood Service NSTOB, Institute Springe, Springe, Germany

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