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Abstract：
Serologic RhD-negative red cells can cause anti-D alloimmunization if they carry the Asian-type DEL or other DEL variants. RHD genotyping is a viable countermeasure if available, but inexpensive alternatives are worthy of consideration. RhD-negative blood donors in Japan were studied by anti-D adsorption-elution and RHD genotyping. We collated published case reports of RhD-negative red cell transfusions associated with inexplicable anti-D immunization. Of 2754 serologic RhD-negative donors, 378 were genotyped D/d. Anti-D adsorption-elution revealed 63.5% (240 of 378) to be DEL, of whom 96.7% (232 of 240) had the 1227G > A variant, diagnostic for the Asian-type DEL. All 240 donors also carried at least one C antigen; none had a cc phenotype. The chance of transfusing DEL red cells to genuinely RhD-negative Asian patients (based on a three-unit transfusion) ranges from 16.7% in Korea to 69.4% in Taiwan, versus 0.6% in Germany. Among 22 RhD-negative recipients of serologic RhD-negative red cells, who produced new or increased anti-D antibody titers, all 17 from East Asia were transfused with red cells with a C-positive phenotype or known to be Asian-type DEL or both. Serologic RhD-negative East Asians with a cc phenotype can be red cell donors for RhD-negative recipients, especially those of childbearing potential.
摘要：
如果血清RhD阴性红细胞携带亚洲型DEL或其他DEL变体，则可以引起抗D同种免疫。RHD基因分型是一种可行的对策，如果有的话，但廉价的替代品值得考虑。通过抗D吸附洗脱和RHD基因分型研究了日本的RhD阴性献血者。我们整理了已发表的与无法解释的抗D免疫相关的RhD阴性红细胞输血的病例报告。在2754名血清RhD阴性供体中，378个基因分型为D/d。抗D吸附-洗脱显示63.5%(378个中的240个)是DEL,其中96.7%(240人中的232人)有1227G>A变体，亚洲型DEL的诊断。所有240个供体还携带至少一种C抗原;没有一个具有cc表型。向真正的RhD阴性亚洲患者（基于三单位输血）输注DEL红细胞的机会从韩国的16.7％到台湾的69.4％，德国为0.6%。在22例RhD阴性的RhD阴性红细胞受体中，产生新的或增加的抗D抗体滴度的人，来自东亚的所有17例患者均接受C阳性表型或已知为亚洲DEL或两者的红细胞输注.具有cc表型的血清学RhD阴性东亚人可以是RhD阴性接受者的红细胞供体，尤其是那些有生育潜力的人。
