Rh Variability in Multi-Ethnic Perspective: Consequences for RH Genotyping

The RhD bloodgroup was first described by Levine en Stetson in 1939 after the manifestation of a hemolytic transfusion reaction in a woman who recently gave birth, after transfusion with her husbands red cells. The RhD-negative woman produced antibodies against the RhD present on the red cells of her child. The child inherited the antigenic character from her father. Nowadays, the initial antibody production in pregnant women is prevented by means of anti-D prophylaxis because this antibody may cause severe hemolytic disease of the newborn in a next pregnancy. Also, the presence of anti-D in a patient who is transfused with RhD-positive red cells may give rise to a severe hemolytic transfusion reaction. The Rh phenotype can be determined by means of serological techniques based on agglutination of a known antibody (anti-D in this case) with the erythrocytes. In cases where no red cells are available (like in prenatal diagnostics) or when serological testing is hampered (like after a recent transfusion or when it is difficult to obtain the antibody) the Rh phenotype can be predicted from DNA analysis. To be able to make a reliable prediction of the Rh phenotype, it is important to genotype on those DNA stretches that are the least prone to changes and that are equal among different ethnic groups. The research described in this thesis has tried to map the ethnic differences in RH genes and to develop reliable genotyping methods that can be applied in a multi-ethnic society.

• View at Worldcat

Free Full Text ( Final Version , 6mb )