Rh BG

• Anti-D antibodies are produced when an Rh-negative person receives transfusions or becomes pregnant with an Rh-positive fetus.
• Anti-D antibodies are produced when an Rh negative individual receives Rh positive blood or has contact with Rh positive fetal cells during pregnancy.
• Rh D antigen is present on the surface of red blood cells
• RH Blood group is the most important BG after ABO in transfusion medicine.
• #004 is the designated number for RH blood group
• Landsteiner and Wiener's discovery led to the development of anti-Rh serum, which can be used as a treatment for hemolytic disease of the newborn (HDN).
• In 1952, Dr. James Neel discovered that HDN could be prevented through prophylaxis using anti-Rh immune globulin (IgG) given to Rh-negative women at risk of exposure to Rh-positive fetal cells.
• RH blood group can produce significant hemolytic disease of the fetus and newborn (HDFN) as well as hemolytic transfusion reactions.
• RH blood group one of the most complex of all RBC systems with more than 50 different Rh antigens (61 different antigenic specificities, acc. to Harmening)
• Levine and Stetson described a hemolytic transfusion reaction in an obstetrical patient.
• HISTORY

  Levine and Stetson

  • an antibody isolated from the mother’s serum that reacted both at 37C and at 20C with the father’s RBCs
  • it was postulated that the fetus and father possessed a common factor (Ag) that the mother lacked
  • HDN is also known as erythroblastosis fetalis
• HISTORY

  Landsteiner and Wiener

  • Reported on an antibody made by guinea pigs and rabbits when they are transfused with rhesus monkey RBCs
  • this Ab agglutinated 85% of human RBCs and was named after the Rhesus monkey (Rh)
• • An investigation by Levine and coworkers demonstrated that the agglutinin that had caused the hemolytic transfusion reaction and the antibody described by Landsteiner and Wiener appeared to define the same blood group.
• The name Rh was retained for the human-produced antibody, and the anti-rhesus antibody formed by the animals was renamed anti-LW in honor of those first reporting it (Landsteiner and Wiener).
• anti-LW = originally defined as anti-Rh in early experiments
• 4 Nomenclature

  • Fisher-Race = based on Genetic inheritance
  • Wiener = (based on genetic inheritance)
  • Rosenfield
  • ISBT
• Fisher-Race uses DCE to determine the probability of a particular phenotype
• DCE antigens are used in Fisher-Race
• Fisher-Race theory that antigens of the systems were produced by DCE, which are three closely linked sets of alleles
• Fisher-Race Theory an indie phenotype is reported as DCE rather than CDE because Fisher postulated that the C/c locus lies between D/d and E/e loci
• d = does not represent an Ag, but simply the absence of D Ag
• C, c, E & e = represent actual Ag recognized by specific Ab
• no matter what, DCE/dce gid ang order, nothing else
• Wiener (Rh-Hr) is the gene responsible for defining Rh produced an agglutinogen that contained a series of blood factors is an Ag recognized by an Ab
• Rules in Wiener(Rh-Hr)

  • Italics/superscripts are used when describing Rh genes
  • Subscripts - used with the upper case R
  • Superscripts - with lower case r
  • There is no designation in the absence of D Ag
• FISHER-RACE / WIENER

  • D = Rh0
  • C = rh'
  • c = hr'
  • E = rh''
  • e = hr"
• In Wiener

  Single prime (') = C/c
• Double prime (") = E/e
• If rh'/rh" = Upper case (C/E)
• If hr'/hr" = Lower case (c/e)
• R denotes the presence of original factor, D Ag
• r denotes the absence of D Ag
• In Wiener

  1 denotes C Ag (if c Ag = not 1)
• In wiener

  2 denotes E Ag (if e Ag = not 2)
• z = if both C and E are capital with the R/D Ag
• y = if both C and E are capital with no R/D Ag
• 0 = if both c and e lower case, will only show for R and not for r
• • ‘ / “ / y = partnered with r
• • o / 1 / 2 / z = partnered with R
• Ok