Guzijan Gordana, Jovanovic Srzentic Snezana, Pavlovic Jankovic Natasa, Djilas Iva, Lilić Marko
Institute for Transfusion Medicine of Republika Srpska, Banja Luka, Bosnia and Herzegovina, Belgrade, Serbia.
Medical Faculty, University of Banja Luka, Banja Luka, Bosnia and Herzegovina, Belgrade, Serbia.
Transfus Med Hemother. 2019 Apr;46(2):114-120. doi: 10.1159/000496751. Epub 2019 Feb 15.
Determination of RhD variants in blood donors, pregnant women, and newborns is important for transfusion strategies, in order to prevent RhD alloimmunisation and hemolytic disease of fetuses and newborns. Implementation of molecular RHD typing in two transfusion institutes is presented in this article, from Banja Luka (Bosnia and Herzegovina) and Belgrade (Serbia).
Blood donors' RhD was checked by direct agglutination assays (tube) and indirect antiglobulin test (gel). Molecular RHD typing was performed by PCR-SSP with fluorometric signal detection in both centres. Donors were selected by weak RhD serological reactivity (Banja Luka, 85 samples; Belgrade, 62 samples) or serologically RhD-negative C/E-positive results (Banja Luka, 92 samples; Belgrade, 61 samples).
Among serologically determined weak D donors from the institute from Banja Luka, weak D type 3 was the most frequent (58.8%), followed by type 1 (35.3%) and DNB (1.2%), whereas results obtained at the Belgrade institute were distributed between weak D type 1 (41.9%), type 3 (30.7%), type 14 (6.5%), type 15 (1.6%), and DNB with anti-D (1.6%). In 17.7% of serologically typed weak D samples from the Belgrade institute, the molecular typing result was standard D. Additionally, RHD presence was detected in 9.8% of serologically RhD-negative, C/E-positive samples from both institutes.
Rh molecular testing was successfully implemented in both blood transfusion institutes in Banja Luka and Belgrade. This study proved the efficiency of serological algorithms for weak D, as well as the presence of the RHD gene among serologically tested RhD-negative, C/E-positive samples.
确定献血者、孕妇和新生儿的RhD变异体对于输血策略很重要,以预防RhD同种免疫以及胎儿和新生儿溶血病。本文介绍了波斯尼亚和黑塞哥维那巴尼亚卢卡以及塞尔维亚贝尔格莱德的两家输血机构开展分子RHD分型的情况。
通过直接凝集试验(试管法)和间接抗球蛋白试验(凝胶法)检查献血者的RhD。两个中心均采用带荧光信号检测的PCR-SSP进行分子RHD分型。根据RhD血清学反应性较弱(巴尼亚卢卡,85份样本;贝尔格莱德,62份样本)或血清学RhD阴性、C/E阳性结果(巴尼亚卢卡,92份样本;贝尔格莱德,61份样本)选择献血者。
在巴尼亚卢卡机构血清学确定的弱D献血者中,弱D 3型最为常见(58.8%),其次是1型(35.3%)和DNB(1.2%),而在贝尔格莱德机构获得的结果分布在弱D 1型(41.9%)、3型(30.7%)、14型(6.5%)、15型(1.6%)以及含抗-D的DNB(1.6%)之间。在贝尔格莱德机构血清学分型的弱D样本中,17.7%的分子分型结果为标准D。此外,在两家机构血清学RhD阴性、C/E阳性的样本中,9.8%检测到RHD存在。
Rh分子检测在巴尼亚卢卡和贝尔格莱德的两家输血机构均成功实施。本研究证明了弱D血清学算法的有效性,以及在血清学检测的RhD阴性、C/E阳性样本中存在RHD基因。