{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T14:03:04Z","timestamp":1770818584998,"version":"3.50.1"},"reference-count":50,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T00:00:00Z","timestamp":1748304000000},"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":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Some D variants, especially those expressed by hybrid alleles, can react falsely negative in routine serology tests. Recently, an increasing number of facilities have strived to implement a method for <jats:italic>RHD<\/jats:italic> molecular screening in blood donors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design and Methods<\/jats:title><jats:p>The participants in this two\u2010year prospective study were 735 unrelated voluntary blood donors from northwestern Croatia. Blood donors were individually tested for <jats:italic>RHD<\/jats:italic> sequences by qPCR. In reactive samples, D antigen was confirmed by adsorption\/elution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:italic>RHD<\/jats:italic> screening was performed by examination of <jats:italic>RHD<\/jats:italic> exons 3, 5, and 10 in 589\/704 (83.7%) serologically D\u2010negative ccee samples, all being negative. Serology results of the Rh phenotype (C+ and\/or E+) were confirmed by qPCR in the remaining 115 donors (16.3%). In this group, 112 donors were <jats:italic>RHD<\/jats:italic>\u2010negative. <jats:italic>RHD<\/jats:italic> DEL alleles were determined in two Ccee donors (0.28%): <jats:italic>RHD*DEL32<\/jats:italic> and <jats:italic>RHD*DEL44<\/jats:italic>. One donor (0.14%) was homozygous for <jats:italic>RHD<\/jats:italic> deletion but revealed an <jats:italic>RHD<\/jats:italic> sequence in 5\u2032\u2010UTR within the <jats:italic>RHCE<\/jats:italic> locus, c.\u2010132A. All three donors with Rh variants expressed D epitopes as displayed by adsorption\/elution. The serologically weak D group (31 participants) contained seven <jats:italic>RHD<\/jats:italic> alleles.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>This study reports the DEL phenotype of <jats:italic>RHD*DEL44<\/jats:italic> expression. The hybrid allele <jats:italic>RHCE*D(1)\u2010CE<\/jats:italic> was described previously, but here we illustrate the presence of D epitope(s) in a donor with homozygous <jats:italic>RHD<\/jats:italic> deletion. <jats:italic>Weak D type 40<\/jats:italic> haplotype association was elucidated. Blood donor molecular Rh testing can prevent the immunization of genuine D\u2010negative patients by D\u2010positive units that reacted negatively in routine serological testing.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.18294","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T13:52:43Z","timestamp":1748353963000},"page":"1319-1327","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Uncommon <scp><i>RHD<\/i><\/scp> variants and an unconventional <scp><i>RHCE<\/i><\/scp> hybrid allele with D epitope expression in blood donors from northwestern Croatia"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4017-4622","authenticated-orcid":false,"given":"Marko","family":"Lili\u0107","sequence":"first","affiliation":[{"name":"Department of Biology Josip Juraj Strossmayer University of Osijek  Osijek Croatia"},{"name":"School of Medicine University of Mostar  Mostar Bosnia and Herzegovina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gordana","family":"Jaklin","sequence":"additional","affiliation":[{"name":"Transfusion Medicine Department General Hospital Vara\u017edin  Vara\u017edin Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koraljka","family":"Goj\u010deta","sequence":"additional","affiliation":[{"name":"Clinical Department for Transfusion Medicine and Transplantation Biology University Hospital Centre Zagreb  Zagreb Croatia"},{"name":"University of Applied Health Sciences  Zagreb Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6588-7886","authenticated-orcid":false,"given":"Mirela","family":"Raos","sequence":"additional","affiliation":[{"name":"Clinical Department for Transfusion Medicine and Transplantation Biology University Hospital Centre Zagreb  Zagreb Croatia"},{"name":"University of Applied Health Sciences  Zagreb Croatia"},{"name":"School of Medicine University of Zagreb  Zagreb Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Branka","family":"Golubi\u0107\u2010\u0106epuli\u0107","sequence":"additional","affiliation":[{"name":"Clinical Department for Transfusion Medicine and Transplantation Biology University Hospital Centre Zagreb  Zagreb Croatia"},{"name":"University of Applied Health Sciences  Zagreb Croatia"},{"name":"School of Medicine University of Zagreb  Zagreb Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,5,27]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"International Society for Blood Transfusion.Table of blood group antigens within systems v12.3 31\u2010JUL\u20102023 [Internet].2023[accessed 10.10.2023] Available at:https:\/\/www.isbtweb.org\/resource\/tableofbloodgroupantigenswithinsystems.html"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V95.12.3662.012k12_3662_3668"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.12275"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781118493595.ch5"},{"key":"e_1_2_9_6_1","unstructured":"International Society for Blood Transfusion.(ISBT 004) RHD blood group alleles v6.4 31\u2010JUL\u20102023 [Internet].2023[accessed 10.10.2023] Available at:https:\/\/www.isbtweb.org\/resource\/004rhd.html"},{"key":"e_1_2_9_7_1","unstructured":"International Society for Blood Transfusion.(ISBT 004) RHCE blood group alleles v6.2\u201031\u2010MAR\u20102022 [Internet].2022[accessed 7.7.2023] Available at:https:\/\/www.isbtweb.org\/resource\/004rhce.html"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.21307\/immunohematology-2019-412"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.21307\/immunohematology-2019-168"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2007.01551.x"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.15741"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2005.00625.x"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V95.8.2699"},{"key":"e_1_2_9_14_1","unstructured":"Croatian Institute for Transfusion Medicine.Guidelines for immunohematological testing of blood donors in transfusion medicine practice in Republic of Croatia. [in Croatian] Preporuke za imunohematolo\u0161ko testiranje davatelja krvi u transfuzijskoj djelatnosti RH.2016[accessed on 7.7.2023] Available at:https:\/\/hztm.hr\/wp-content\/uploads\/2018\/09\/Preporuke-za-IH-testiranje-davatelja-krvi-u-transfuzijskoj-djelatnosti-RH-velja\u010da-2016..pdf"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0041-1132.2004.04211.x"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1159\/000366176"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmrv.2021.04.002"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.12941"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2002-03-0742"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.16242"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.12230"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.14425"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.12851"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.16233"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2008.02046.x"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transci.2014.02.009"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transci.2014.02.011"},{"issue":"1","key":"e_1_2_9_28_1","first-page":"25","article-title":"RHD null alleles in the Portuguese population","volume":"19","author":"Pereira J","year":"2009","journal-title":"Transfus Med"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1423-0410.2009.01181.x"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1159\/000370217"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/tme.12211"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.12701"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1159\/000479239"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.15504"},{"issue":"3","key":"e_1_2_9_35_1","first-page":"189","article-title":"Breakpoint regions of an RHD\u2010CE(4\u20109)\u2010D allele and a rare JK allele in a Pacific islander individual","volume":"22","author":"Srivastava K","year":"2024","journal-title":"Blood Transfus"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0958-7578.2004.00496.x"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1423-0410.2006.00886.x"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.12554"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-021-24445-6"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V93.1.385"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3148.2005.00638.x"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.16518"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transci.2021.103142"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/tme.12944"},{"issue":"1","key":"e_1_2_9_45_1","first-page":"25","article-title":"Ten years clinical experience with RHD alleles identification [in Croatian] Deset godina klini\u010dkog iskustva s identifikacijom RHD alela","volume":"139","author":"Goj\u010deta K","year":"2017","journal-title":"Lijec Vjesn"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1159\/000496751"},{"issue":"2","key":"e_1_2_9_47_1","first-page":"97","article-title":"Molecular typing of RhD\u2010negative blood donors with C and\/or E antigen","volume":"50","author":"Guzijan G","year":"2019","journal-title":"Scr Med"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.41.5.283"},{"issue":"1","key":"e_1_2_9_49_1","first-page":"3","article-title":"Six new RHD alleles with previously unknown polymorphisms","volume":"30","author":"Doscher A","year":"2003","journal-title":"Transfus Med Hemother"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.12413"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.16100"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.18294","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T17:49:55Z","timestamp":1751651395000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/trf.18294"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,27]]},"references-count":50,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1111\/trf.18294"],"URL":"https:\/\/doi.org\/10.1111\/trf.18294","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"value":"0041-1132","type":"print"},{"value":"1537-2995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,27]]},"assertion":[{"value":"2023-07-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}