Author/Editor		Mrak, Janja; Železnik, Klara; Dovč, Tadeja; Bricl, Irena
Title		Obravnava nosečnic glede na tip RhD
Translated title		Treatment of pregnant women by RhD type
Type		članek
Vol. and No.		Letnik 88, št. 11/12
Publication year		2019
Volume		str. 582-592
ISSN		1318-0347 - Zdravniški vestnik : glasilo Slovenskega zdravniškega društva : Slovenian medical journal
Language		slv
Abstract		An accurate determination of RhD (D) antigen (Ag) is important for pregnant women, transfusion recipients and blood donors. The decision to receive the pre- and postnatal prophylaxis with anti-D immunoglobulin (RhIG) is based on the D-type. Individuals can be classified as D-posi- tive (D-pos) or D-negative (D-neg) based on the determination of Ag D but there are numerous other versions of Ag D as well (variants D, D-var). Allele variants of the RHD (D) gene can encode different forms of protein D. They are divided into weak, partial and D el . Ag D are determined on the basis of serological techniques. If in doubt, we use the molecular-biological methods for determining the D gene. The definitive definition of D-var is given on the basis of the molecular - -biological methods . From the peripheral venous blood samples taken from pregnant women, we roughly determi- ned Ag D on plates (the Seraclone anti-D reagent) and on gel cards (the DiaClon ABO / D + Re verse Grouping test system (monoclonal antibodies) (Bio-Rad, Germany), with which we do not detect D category VI blood group). For 49 pregnant women we performed extended serological tests of D blood group (commercial ID-Partial RhD Typing Set (Bio-Rad, Germany)). We procee - ded with molecular-biological methods: DNA isolation (utilisation of the BioRobot EZ1 and the commercial set EZ1 DNA Blood 350 %l Kit (Qiagen, Germany)), determination of the genotype D with the PCR-SSP method (commercial RBC-Ready Gene CDE, RBC -Ready Gene D weak and RBC-Ready Gene D AddOn (Inno-Train; Germany)), amplification (Veriti apparatus (Apllied Bio - Systems, USA)), product separation (electrophoretic system (BioRad, USA) on agarose gel (Si- gma, Germany). Our results showed that weak D forms represented 41 cases (83.7 %) and partial forms 8 cases (16.3 %) of all D-var. The most common D-var in pregnant women was weak D type 1 with 17 ca- ses (34.7 %), followed by weak D type 3 with 13 cases (26.5 %) and weak D type 2 with 10 cases (20.4 %). The most common partial D form was D category VII with 5 cases (10.2 %). Pregnant women and transfusion recipients who are carriers of weak D types 1, 2 or 3 can be safely treated as D-pos, while carriers of all other D-var can be treated as D-neg. Blood donors with D-var are treated as D-pos. By means of this algorithm, approximately 172 unnecessary RhIG applications can be prevented annually and adequate supplies of D-neg erythrocyte blood com- ponents can be maintained.
Keywords		variante D šibki D parcialni D variants D weak D partial D