• Before 1939 - Morbidity

and mortality in ABO

compatible transfusions
• Levine and Stetson –
antibody from mother
• Landsteiner and Weiner –
antibody from guinea pigs
and rabbits transfused
with rhesus monkey RBCs
• Levine and co-workers –
said the two antibodies
are the same
• Renaming to anti-LW
• 1940’s – 5 antigens
• 50 different specificities
• Chromosome 1p36.11
• Codominant
• RHD and RHCE
• polymorphic
• Gene codes for the
antigen or blood factor
itself
• Depends on the
terminology
Postulated Genetic
Mechanism
• Fisher-Race: The DCE
terminology
• Wiener: The Rh-Hr
terminology
Presence or absence of Ag
• Rosenfield and Coworkers:
Alpha/Numeric Terminology
Working Party on
Terminology for Red Cell
Surface Ag
• Closely-linked genes: D, d,
C, c, E, e
• Antigens: D, d, C, c, E, e
• “d” represents the
absence of D antigen
• Disadvantages: Cannot
report
– Newer Rh antigens
– Rhmod and Rhnull
• Rh gene produces at least
3 factors within an
agglutinogen
• Fisher-race can be
converted to Wiener
• Rh1 – D
• Rh2 – C
• Rh3 – E
• Rh4 – c
• Rh5 – e
• Ex: Rh: 1, 2, 3, -4
Rh: 1, 2, 3, -4, -5
• Similar to Rosenfield
• Transmembrane
polypeptides
• Non-glycosylated proteins
• Highly immunogenic
• D is most potent
• D>c>E>C>e
• Weak D (Du phenotype):
– Genetic weak D
– C Trans
– Partial D (mosaic) – must be
given Rh (D) negative
• Immune antibodies
• IgG class
• Delayed HTR
• HDN (esp on the 2nd
pregnancy), becomes
severe in ABO compatible
pregnancies
• Saline-based
• High protein-based
• Low protein-based
• Chemically modified
• Monoclonal
• Blends of monoclonal
• Cw
• f(ce)
• rhi(Ce)
• G
• Rh:13, Rh:14, Rh:15, Rh:16
• Hro
• Rh:23, Rh:30, Rh:40
• Rh:33
• Rh:32
• e Variants
• V, VS
• Deletions