Department of Pathology and Laboratory Medicine, MedStar Georgetown University Hospital, Washington, DC.
Department of Laboratory Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, Maryland.
Transfusion. 2019 Jul;59(7):2455-2458. doi: 10.1111/trf.15323. Epub 2019 Apr 22.
In 2005, the late George Garratty asked readers of , “Do we need to be more concerned about weak D antigens?” His question was prompted by his observation that “… there have been increasing numbers of reports of patients who had been transfused with donor blood having ‘weak D’ or undetectable D (e.g., DEL) who made anti-D.” Garratty reviewed the complexity of the D antigen and its variants, case reports of anti-D after transfusion of weak D RBCs to D- recipients, and variable D typing results depending on selection of anti-D reagents. He noted that most available data were from Europe and concluded that “countries with larger Asian or African populations … need to relate to statistics in their own countries.” Garratty’s question can be answered only when data are available for the many different scenarios in which different categories of weak D RBCs have been transfused to D- recipients. In this commentary, we address one of these scenarios, namely, the potential risk of D alloimmunization when Asian-type DEL (*) RBCs are transfused to D- recipients in the United States. We suggest how this issue can be resolved by a focused study in pertinent communities in the United States.
2005 年，已故的乔治·加拉蒂（George Garratty）在《免疫血液学杂志》（ Transfusion ）的读者中问道：“我们是否需要更加关注弱 D 抗原？”他的问题源于他的观察，即“……越来越多的报告显示，输注供体血液的患者具有‘弱 D’或无法检测到的 D（例如，DEL），并产生抗-D”。加拉蒂回顾了 D 抗原及其变体的复杂性、输注弱 D RBC 给 D-受者后发生抗-D 的病例报告，以及根据抗-D 试剂的选择而导致的可变 D 型结果。他指出，大多数可用数据来自欧洲，并得出结论：“具有较大亚洲或非洲人口的国家……需要根据自己国家的统计数据来进行处理。”只有在具有不同类别的弱 D RBC 输注给 D-受者的许多不同情况下获得数据时，才能回答加拉蒂的问题。在本评论中，我们讨论了其中一种情况，即在向美国的 D-受者输注亚洲型 DEL（*）RBC 时，潜在的 D 同种免疫风险。我们建议如何通过在美国相关社区进行重点研究来解决这个问题。
