title: Weak D type 67 in four related Canadian blood donors.
abstract: Correct donor D typing is critical to prevent recipient alloimmunization. No method can detect all variants, and the immunogenicity of many variants is unknown. Routine ABO and D serologic typings are performed in our laboratory by automated microplate testing. Until 2011, routine confirmation of D- status of first-time donors was performed by the manual tube indirect antiglobulin test (IAT); this was replaced by automated solid-phase testing including weak D testing by IAT. Selected donors are investigated by other methods. We describe four weak D type 67 (RHD*01W.67) donors whose samples tested as D- by automated microplate and manual methods but were later determined to be D+ by automated solid-phase and RHD gene analysis. Solid-phase serologic and molecular typing results of all four donors were identical. It was identified that the donors are of English-Irish descent; two are brothers and the others are cousins. Transfusion of blood from one of these donors likely resulted in alloimmunization to D in one of three recipients tested since no other documented exposures were identified. Lookback studies determined that two other D- recipients were not alloimmunized.
authors.affiliation: The Ottawa Hospital, General Campus, Department of Laboratory Medicine, 501 Smyth Road, Ottawa, Ontario, Canada, K1H 8L6.
authors.forename: Philip
authors.initials: P
authors.lastname: Berardi
authors.affiliation: Canadian Blood Services, Donor Testing, Calgary, Alberta, Canada.
authors.forename: Emma
authors.initials: E
authors.lastname: Bessette
authors.affiliation: Canadian Blood Services, Donor Testing, Calgary, Alberta, Canada.
authors.forename: Michiko
authors.initials: M
authors.lastname: Ng
authors.affiliation: Director, Canadian Blood Services, Toronto, Ontario, Canada.
authors.forename: Nancy
authors.initials: N
authors.lastname: Angus
authors.affiliation: Director, Canadian Blood Services, Toronto, Ontario, Canada.
authors.forename: Debra
authors.initials: D
authors.lastname: Lane
authors.affiliation: Canadian Blood Services, Medical Services and Innovation, Winnipeg, Manitoba, Canada.
authors.forename: Lise
authors.initials: L
authors.lastname: Gariepy
authors.affiliation: St. Michael's Hospital, Transfusion Medicine, Toronto, Ontario, Canada.
authors.forename: Katerina
authors.initials: K
authors.lastname: Pavenski
authors.affiliation: Scientific Director, Grifols Immunohematology Center, San Marcos, TX.
authors.forename: Gorka
authors.initials: G
authors.lastname: Ochoa-Garay
authors.affiliation: Canadian Blood Services, National Immunohematology Reference Lab, Ottawa, Ontario, Canada.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Cote
authors.affiliation: Canadian Blood Services, Medical Services and Innovation, Ottawa, Ontario, Canada.
authors.forename: Mindy
authors.initials: M
authors.lastname: Goldman
mesh_terms: D001782:Blood Donors; D002170:Canada; D006650:Histocompatibility Testing; D006801:Humans; D008297:Male; D012204:Rh-Hr Blood-Group System / Q000235:genetics*
chemical_list: D012204:Rh-Hr Blood-Group System