D testing requirements for donors and patients

[k1065]

In the UK, D testing is performed on donors using antisera capable of detecting DIV, DV and DVI types. Such patients are grouped as RhD positive. This is due to the high likelihood of immunisation should an RhD negative individual recive blood from one of these donors. On the patient testing side, the antisera used for D grouping should not detect DVI and such patients would be grouped as RhD negative. The BSH guidelines specify that antisera which does not detect DVI should be used in pre-transfusion testing however mentions nothing regarding the ability of the antisera to detect DIV and DV. Why on the patient testing side are we not concerned about DIV and DV when such donors are specifically being targeted?

Many thanks

 

[Malcolm Needs ☆]

That is because, although such individuals (DIV and DV) can make allo-anti-D, they are far less likely to so do.

If you look at the exons involved in the DIV and DV mutations, compared with those of the DVI mutations, this becomes much clearer (see attached).

DIV DV DVI Mutations.pptx

[k1065]

Thanks Malcolm,

Thats great and very helpful.