Abstract

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With the advent of red cell genotyping and the emphasis on precision medicine, transfusion strategy should be based on molecular typing whenever a serologic weak D phenotype1 is detected in patients, including pregnant women, newborns, and potential transfusion recipients. A US-based Work Group concluded in March 2015 that such patients carrying any of the 3 molecular weak D types most prevalant in Caucasians should be treated as D positive, receiving D-positive red cell transfusions and no RhIG administration2,3. The recommendation has practical relevance for all European populations2 because it concerns their prevalent weak D types, even though prevalence varies4-6 and an even greater diversity is observed in subtypes7. The Work Group rated this as a strong recommendation, based on high-quality evidence from observational studies, but limited its recommendation to weak D types 1, 2, and 3, which is standard practice in many European health care systems. However, one issue had remained under discussion, as a recommendation for weak D types 4.0 and 4.1 had been postponed until more data were available. Now this time has come. [ … ]

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Authors

Willy A. Flegel - Department of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, MD; Department of Pathology and Laboratory Medicine, MedStar Georgetown University Hospital, Washington DC, United States of America

Thierry Peyrard - Centre National de Référence des Groupes Sanguins, INTS, Paris

Jacques Chiaroni - Etablissement Français du Sang, Marseille; Aix Marseille University, CNRS, ADES, Marseille

Christophe Tournamille - Etablissement Français du Sang Île de France; Institut National de la Santé et de la Recherche Médicale (INSERM)-U955, Equipe 2: Transfusion et Maladies du Globule Rouge, Institut Mondor de Recherche Biomédicale, Créteil

Déborah Jamet - Etablissement Français du Sang, Brest, France

France Pirenne - Etablissement Français du Sang Île de France; Institut National de la Santé et de la Recherche Médicale (INSERM)-U955, Equipe 2: Transfusion et Maladies du Globule Rouge, Institut Mondor de Recherche Biomédicale, Créteil

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