{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T17:34:17Z","timestamp":1791048857772,"version":"4.1.0"},"reference-count":49,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T00:00:00Z","timestamp":1713398400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>For patients with weak or discrepant RhD RBC phenotypes, <jats:italic>RHD<\/jats:italic> genotyping is employed to determine need for RhD\u2010negative management. However, many <jats:italic>RHD<\/jats:italic> variants are type D\u2010negative or D\u2010positive. Serological recognition rates (RRs) of weak and partial <jats:italic>RHD<\/jats:italic> variants are poorly characterized.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design and Methods<\/jats:title><jats:p>Four US studies employing <jats:italic>RHD<\/jats:italic> genotyping for weak or discrepant RhD phenotypes provided data for race\/ethnicity\u2010specific serological recognition. Three studies used microplate, and 1 used gel and tube; 2 had anti\u2010D data. We obtained White and Hispanic\/Latino allele frequencies (AFs) of weak D types 1, 2, and 3 single\u2010nucleotide variants (SNVs) from the Genome Aggregation Database (gnomAD, v4.0.0) and devised Hardy\u2013Weinberg\u2010based formulas to correct for gnomAD's overcount of hemizygous <jats:italic>RHD<\/jats:italic> SNVs as homozygous. We compiled common partial <jats:italic>RHD<\/jats:italic> AF from genotyped cohorts of US Black or sickle cell disease subjects. From variant AF, we calculated hemizygous\u2010plus\u2010homozygous genetic prevalences. Serological prevalence: genetic prevalence ratios yielded serological RRs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall RRs of weak D types 1\u20133 were 17% (95% confidence interval 12%\u201324%) in Whites and 12% (5%\u201327%) in Hispanics\/Latinos. For eight partial <jats:italic>RHD<\/jats:italic> variants in Blacks, overall RR was 11% (8%\u201314%). However, DAR RR was 80% (38%\u2013156%). Compared to microplate, gel\u2013tube recognition was higher for type 2 and DAU5 and lower for type 4.0. Anti\u2010D was present in 6% of recognized partial <jats:italic>RHD<\/jats:italic> cases, but only in 0.7% of estimated total genetic cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Based on AF, &gt;80% of patients with weak or partial <jats:italic>RHD<\/jats:italic> variants were unrecognized serologically. Although overall anti\u2010D rates were low, better detection of partial <jats:italic>RHD<\/jats:italic> variants is desirable.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.17810","type":"journal-article","created":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T07:03:57Z","timestamp":1713423837000},"page":"920-928","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Estimating the serological underrecognition of patients with weak or partial <scp><i>RHD<\/i><\/scp> variants"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9721-5259","authenticated-orcid":false,"given":"Glenn","family":"Ramsey","sequence":"first","affiliation":[{"name":"Department of Pathology, Feinberg School of Medicine Northwestern University  Chicago Illinois USA"},{"name":"Blood Bank, Northwestern Memorial Hospital  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1667-7505","authenticated-orcid":false,"given":"Christina M.","family":"Barriteau","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Pediatrics, Feinberg School of Medicine Northwestern University  Chicago Illinois USA"},{"name":"Blood Bank, Ann and Robert H. 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