Trial reportTransfusion2018
Transfusion strategy for weak D Type 4.0 based on RHD alleles and RH haplotypes in Tunisia.
Trial report in Transfusion, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 27 citations in OpenAlex.
- Evaluation of Six Large Language Models for Clinical Decision Support: Application in Transfusion Decision-making for RhD Blood-type Patients.Annals of laboratory medicine · 2025Article
- A Bioinformatically Initiated Approach to Evaluate GATA1 Regulatory Regions in Samples with Weak D, Del, or D- Phenotypes Despite NormalTransfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie · 2024Article
- Proceed with care: the "uncommon" serologic weak D phenotypes.Blood transfusion = Trasfusione del sangue · 2021Article
- What constitutes the most cautious approach for a pregnant person with weak D type 4.0?CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2021Article
- Transfusion support during childbirth for a woman with anti-U and theImmunohematology · 2021Article
- It's time to phase out "serologic weak D phenotype" and resolve D types with RHD genotyping including weak D type 4.Transfusion · 2020Article
- Implementation of MolecularTransfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie · 2019Article
- A proposal for a rational transfusion strategy in patients of European and North African descent with weak D type 4.0 and 4.1 phenotypes.Blood transfusion = Trasfusione del sangue · 2019Article
- Comprehensive phenotypic and molecular investigation of RhD and RhCE variants in Moroccan blood donors.Blood transfusion = Trasfusione del sangue · 2019Article
- High frequency of variant RHD genotypes among donors and patients of mixed origin with serologic weak-D phenotype.Journal of clinical laboratory analysis · 2018Article
- Genotyping in Sickle Cell Disease Patients: The French Strategy.Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie · 2018Review
- High prevalence of serological weak D phenotype and preponderance of weak D type 4.0.1. genetic variant in a Nigerian population: implications for transfusion practice in a resource-limited setting.Hematology, transfusion and cell therapyArticle
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5 authors at 2 institutions in 3 countries.
Funding
Abstract
backgroundWith more than 460 RHD alleles, this gene is the most complex and polymorphic among all blood group systems. The Tunisian population has the largest known prevalence of weak D Type 4.0 alleles, occurring in one of 105 RH haplotypes. We aimed to establish a rationale for the transfusion strategy of weak D Type 4.0 in Tunisia. STUDY DESIGN AND
methodsDonors were randomly screened for the serologic weak D phenotype. The RHD coding sequence and parts of the introns were sequenced. To establish the RH haplotype, the RHCE gene was tested for characteristic single-nucleotide positions.
resultsWe determined all RHD alleles and the RH haplotypes coding for the serologic weak D phenotype among 13,431 Tunisian donations. A serologic weak D phenotype was found in 67 individuals (0.50%). Among them, 60 carried a weak D Type 4 allele: 53 weak D Type 4.0, six weak D Type 4.2.2 (DAR), and one weak D Type 4.1. An additional four donors had one variant allele each: DVII, weak D Type 1, weak D Type 3, and weak D type 100, while three donors showed a normal RHD sequence. The weak D Type 4.0 was most often linked to RHCE*ceVS.04.01, weak D Type 4.2.2 to RHCE*ceAR, and weak D Type 4.1 to RHCE*ceVS.02, while the other RHD alleles were linked to one of the common RHCE alleles.
conclusionsAmong the weak D phenotypes in Tunisia, no novel RHD allele was found and almost 90% were caused by alleles of the weak D Type 4 cluster, of which 88% represented the weak D Type 4.0 allele. Based on established RH haplotypes for variant RHD and RHCE alleles and the lack of adverse clinical reports, we recommend D+ transfusions for patients with weak D Type 4.0 in Tunisia.
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