Nh÷ng hiÓu biÕt vÒ c¸c nhãm m¸u ngoµi hÖ ABO
®Æt vÊn ®Ò
C¸c hÖ nhãm m¸u HC vµ kh¸ng nguyªn nhãm m¸u đã được Hội TMQT công nhận
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HÖ nhãm m¸u Rh
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Kh¸ng nguyªn D („yÕu tè Rh“)
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Sù kh¸c nhau vÒ sè lîng vµ chÊt lîng cña Du vµ D tõng phÇn
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HÖ nhãm m¸u Kell
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HÖ nhãm m¸u Kidd
KiÓu h×nh vµ tÇn suÊt cña hÖ nhãm m¸u Kidd
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hÖ Nhãm m¸u Duffy
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HÖ nhãm m¸u Lewis
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HÖ nhãm m¸u MNSs
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HÖ nhãm m¸u P
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The RH genes: RHD and RHCE
The D antigen („Rh factor“)
D = most immunogenic red cell antigen
The serologic spectrum of D antigen expression
Dweak
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Weak D types: reduced D antigen numbers
D antigen density determination
Typical D antigen densities
Qualitative analysis of the D antigen
Anti-D panel for routine serology
D epitope profiles of partial D types
The upper end of the spectrum…
An „almost normal“ partial D: DWI
Crossmatch with DWI-positive relatives
Immunogenicity of very weak RhD variants
DEL = extremely weak RhD variants
DEL: RHD missense and splice site mutations
Anti-D immunization by DEL transfusion
DEL antigen expression
DEL red cells with anti-D in IAT
Serologic detection of DEL by adsorption/elution
Epitope mapping of RHD(IVS3+1g>a) with IgG anti-D monoclonal antibodies
Adsorption/elution with IgM anti-D
DEL epitope mapping by adsorption/elution
Alloanti-D in partial DEL individuals
A continuum: Dweak ↔ DEL
The spectrum of D expression
Clinical implications
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Acquired Rh phenotype changes
Mixed-field agglutination in blood grouping
Spontaneous mixed-field Rh typing
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Haplotypic Rh antigen loss ?
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…zygosity
Microsatellite marker analysis: no chimerism
Microsatellite markers on chromosome 1
LOH on chromosome 1
Variable expansion of LOH
Nucleated erythroid precursors: BFU-E
RH-PCR of single BFU-E colonies
LOH only in RHD− BFU-E colonies
FISH: 1p (RH, green) and 1q (red)
Myeloid stem cells with LOH
Gene dose and Rh antigen expression
Spontaneous Rh phenotype splitting
Contributing scientists