Abstract

Background. To date, more than 650 (weak and partial) Rh variants have been reported. Nature and frequency of these variants are known to be ethnodependent. In transfusion medicine, their identification is important to ensure blood safety. The aim of this study is to investigate and describe the nature and estimate the frequency of Rh variants in blood donors in Morocco by serological tests and molecular analysis.
Materials and methods. Blood samples from 4,458 blood donors were collected and typed for Rh antigens (D, C, c, E and e) by an automated system with monoclonal antibodies. RhD-negative samples were tested for weak D expression by indirect antiglobulin test (IAT), as well as weak C, c, E, and e expression with monoclonal antibodies, by column agglutination technique. All samples exhibiting a weak D agglutination by the automated system and IAT were tested for partial D. RHD and RHCE genes were analysed by quantitative multiplex PCR of short fluorescent fragments (QMPSF) and/or Sanger sequencing.
Results. 4,038 (90.58%) and 420 (9.42%) samples were respectively typed serologically as D-positive and D-negative, including 23 (0.52%) presenting with a weak D phenotype. In 21 weak D samples investigated by molecular analysis, RHD*weak D type 4.0 was found to be the most prevalent variant allele (n=11), and a novel RHD(V270A) missense allele was found once. Variant Rh CcEe antigen expression was observed in 17 samples carrying 20 variant RHCE alleles, including a novel RHCE*ce(499G) missense allele (p.M167V).
Discussion. For the first time, molecular genetics of the Rh system was investigated in the Moroccan population. On the basis of our data and in order to optimise donor/recipient matching to prevent from a potential risk of alloimmunisation in recipients, we suggest that 1) quality control of serological reagents and screening strategies must be reviewed in Morocco, and 2) molecular analysis should be implemented and performed in blood donor centers.

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Authors

Houria El Housse - Laboratory of Haematology, Cellular and Genetic Engineering, Faculty of Medicine and Pharmacy Casablanca, Hassan II University of Casablanca, Casablanca, Morocco

Mariam El Wafi - Laboratory of Haematology, Cellular and Genetic Engineering, Faculty of Medicine and Pharmacy Casablanca, Hassan II University of Casablanca, Casablanca, Morocco

Zainab Ouabdelmoumene - Laboratory of Haematology, Cellular and Genetic Engineering, Faculty of Medicine and Pharmacy Casablanca, Hassan II University of Casablanca, Casablanca, Morocco

Fatima Zarati - Laboratory of Haematology, Cellular and Genetic Engineering, Faculty of Medicine and Pharmacy Casablanca, Hassan II University of Casablanca, Casablanca, Morocco; Regional Blood Transfusion Centre of Casablanca, Casablanca, Morocco

Rachida Alid - Regional Blood Transfusion Centre of Casablanca, Casablanca, Morocco

Nadia Nourichafi - Regional Blood Transfusion Centre of Casablanca, Casablanca, Morocco

Kamal Bouisk - Regional Blood Transfusion Centre of Casablanca, Casablanca, Morocco

Mohammed Benajiba - National Blood Transfusion and Haematology Centre, Rabat, Morocco

Claude Férec - UMR1078 "Génétique, Functional Genomics and Biotechnologies", Inserm, EFS, University of West Bretagne (UBO), IBSAM, CHU de Brest, Brest, France

Yann Fichou - UMR1078 "Génétique, Functional Genomics and Biotechnologies", Inserm, EFS, University of West Bretagne (UBO), IBSAM, CHU de Brest, Brest, France

Norddine Habti - Laboratory of Haematology, Cellular and Genetic Engineering, Faculty of Medicine and Pharmacy Casablanca, Hassan II University of Casablanca, Casablanca, Morocco; National Blood Transfusion and Haematology Centre, Rabat, Morocco

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