Fu Shao-Jie, Feng Yan-Lin, Yu Li-Xin, Miao Yun, Luo Min, Wang Yi-Bin, Li Yi-Chen, Chen Shu-Han, Xiao Lu-Lu
Department of Organ Transplantation, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. E-mail:
Nan Fang Yi Ke Da Xue Xue Bao. 2017 Jun 20;37(6):837-841. doi: 10.3969/j.issn.1673-4254.2017.06.22.
To compare the accuracy of serological and molecular approaches to identification of RhD-negative patients waiting for kidney transplantation.
A total of 103 RhD-negative blood samples by serological test were collected from patients waiting for kidney transplantation between January, 2006 and January, 2016. Quantitative PCR and sequencing were used to verify the results of RHD genotyping, and the false negative rates of the serological and molecular methods for RhD genotyping were compared.
Among the 103 blood samples, true RhD negativity (with all the 10 exons missing) was found in 56 samples (54.5%), and false RhD negativity (RhD positivity with loss, repetition, or missense mutation in the 10 exons) in 47 samples (45.6%). In the 47 false RhD-negative cases, weak D was detected in 1 case (2.1%), partial D in 13 cases (27.7%), and D-elution in 33 cases (70.2%). The detection rates of RhD negativity differed significantly between the serological and molecular methods (P<0.05).
Serological test is associated with a high false negative rate in detecting RhD blood group, and the use of the molecular approach has important clinical significance in accurate RhD genotyping for patients waiting for renal transplantation.
比较血清学方法和分子生物学方法鉴定等待肾移植的RhD阴性患者的准确性。
收集2006年1月至2016年1月期间等待肾移植患者的103份经血清学检测为RhD阴性的血样。采用定量PCR和测序验证RHD基因分型结果,并比较血清学方法和分子生物学方法进行RhD基因分型的假阴性率。
103份血样中,56份(54.5%)为真正的RhD阴性(10个外显子均缺失),47份(45.6%)为假RhD阴性(RhD阳性但10个外显子存在缺失、重复或错义突变)。在47例假RhD阴性病例中,检测到1例弱D(占2.1%)、13例部分D(占27.7%)和33例D-洗脱型(占70.2%)。血清学方法和分子生物学方法检测RhD阴性的比率差异有统计学意义(P<0.05)。
血清学检测RhD血型时假阴性率较高,分子生物学方法对于等待肾移植患者准确进行RhD基因分型具有重要临床意义。