{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T02:04:47Z","timestamp":1747188287450,"version":"3.40.5"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,3,23]],"date-time":"2022-03-23T00:00:00Z","timestamp":1647993600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Exposure to normal or variably expressed RhD antigens in an antigen\u2010negative individual can elicit an immune response and lead to the formation of clinically significant anti\u2010D alloantibodies. We present the case of anti\u2010D alloimmunization by DEL variant missed in routine blood donor screening.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>Blood donors were typed for D antigen using the direct serologic micromethod. Nonreactive samples were confirmed in the indirect antiglobulin method with an IgM\/IgG anti\u2010D monoclonal reagent. Genomic DNA was extracted using a commercial QIAamp DNA Blood Mini kit on the QIAcube device (Qiaqen, Germany). <jats:italic>RHD<\/jats:italic> genotyping was performed using the PCR\u2010SSP genotyping kits\u2010 Ready Gene D weak, Ready Gene D weak screen, Ready Gene CDE, and Ready Gene D AddOn (Inno\u2010Train, Germany). Unidentified alleles were sent for DNA genome sequencing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After identifying DEL positive blood units in RhD negative blood donor pool, a look\u2010back study was performed to determine if their previous donations caused alloimmunization in recipients. Out of 40 D negative recipients, one developed anti\u2010D alloantibody after 45\u2009days. The patient did not receive other RhD positive blood products. Blood donor typed D negative in direct and indirect agglutination method. <jats:italic>RHD<\/jats:italic> screening was positive, but <jats:italic>RHD<\/jats:italic> genotyping and DNA sequencing showed no mutation indicating the normal genotype.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Currently used methods in <jats:italic>RHD<\/jats:italic> genotyping are insufficient to identify many variant alleles, especially intronic variations. We suggest additional gene investigation including yet unexplored regions of regulation and intron regions to justify our serological finding.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.16862","type":"journal-article","created":{"date-parts":[[2022,3,23]],"date-time":"2022-03-23T07:04:32Z","timestamp":1648019072000},"page":"1084-1088","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["<scp>RhD<\/scp> alloimmunization by <scp>DEL<\/scp> variant missed in donor testing"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8981-9247","authenticated-orcid":false,"given":"Hana","family":"Safic Stanic","sequence":"first","affiliation":[{"name":"Department of Immunohematology Croatian Institute of Transfusion Medicine  Zagreb Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vesna","family":"Dogic","sequence":"additional","affiliation":[{"name":"Department of Molecular Diagnostics Croatian Institute of Transfusion Medicine  Zagreb Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jasna","family":"Bingulac\u2010Popovic","sequence":"additional","affiliation":[{"name":"Department of Molecular Diagnostics Croatian Institute of Transfusion Medicine  Zagreb Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zrinka","family":"Kruhonja Galic","sequence":"additional","affiliation":[{"name":"Department of Immunohematology Croatian Institute of Transfusion Medicine  Zagreb Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miljana","family":"Stojic Vidovic","sequence":"additional","affiliation":[{"name":"Department for Blood donor testing Croatian Institute of Transfusion Medicine  Zagreb Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kresimir","family":"Puljic","sequence":"additional","affiliation":[{"name":"Department for woman\u2019s psychotic disorders, University 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