Study of the molecular polymorphism of the Rh blood group system and its relationship with aloimmunization and destruction of red blood cells

Abstract

The Rh system is highly complex with a large number of variants and antigens and is of great interest in transfusion medicine and fetal-maternal due to its involvement in erythrocyte alloimmunization and immune destruction of red blood cells. The identification of phenotypes with altered expression of the RhD antigen is of fundamental importance in transfusion practice and fetal-maternal to ensure safe transfusion and efficient administration of Rh immunoglobulin. However, the large number of RhD variants described and the patterns of variability and reactivity of commercial antisera used in RhD typing are factors that limit the application of serological methods and thus molecular methods have been used to better characterize these variants. Although many polymorphisms responsible for changes in RhD antigen have been described in European populations, we believe that new mutations can still be found in other populations. With a better understanding of the molecular mechanisms involved in the expression of the RhD antigen, it will be possible to predict which individuals phenotypically RhD negative may be safely transfused with RhD positive RBCs. This will be of clinical use for polytransfused patients who have multiple antibodies (AU)