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Accurate Rh phenotype determination by reticulocyte mRNA typing shortly after multiple transfusions

¹ Department of Immunology and Transfusion Medicine, Ulleval University Hospital, Oslo
² Institute of Immunology, University of Oslo and Rikshospitalet University Hospital, Oslo
³ the University of Oslo, Norway

Correspondence: Ingrid Randen, Department of Immunology and Transfusion Medicine, Ulleval University Hospital, Kirkeveien 166, 0407 Oslo, Norway. E-mail: ingrid.randen{at}medisin.uio.no

ABSTRACT

Alloimmunization is a common phenomenon after transfusion, with an estimated incidence of 0.5% increasing to 20–60% in chronically transfused patients. In recently transfused patients, serological typing can be hampered by mixed field agglutination. We established RT-PCR methods for RHD, RHC/c and RHE/e typing using mRNA from reticulocytes. Molecular typing was performed soon after 51 separate mismatched transfusion events involving 30 patients. Accurate identification of the transfused patients’ phenotype was confirmed in all cases. Reticulocyte maturation studies revealed that temperature is a crucial parameter for transition into mature red blood cells.

Key words: multiple transfusions, reticulocytes, molecular RH-typing.