{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T02:28:56Z","timestamp":1786328936811,"version":"build-2736575974"},"reference-count":42,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["156277\/2019\u20100"],"award-info":[{"award-number":["156277\/2019\u20100"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vox Sanguinis"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>\n                      Serological classification of RhD\u2010negative and weak D is often insufficient in admixed populations, where diverse\n                      <jats:italic>RHD<\/jats:italic>\n                      variants have clinical implications. In Brazil's highly admixed population, RhD interpretation and donor\u2013recipient matching are particularly challenging. We used Duffy phenotyping to support ancestry inference and contextualize Rh variants. Understanding\n                      <jats:italic>RHD<\/jats:italic>\n                      alleles and their associations with RhCE and Duffy is essential for transfusion safety. Here, we characterize\n                      <jats:italic>RHD<\/jats:italic>\n                      variants in Brazilian donors and relate them to RhCE and Duffy phenotypes across regions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      We analysed 321 blood donor samples with either weak D expression (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009295) or a D\u2010negative phenotype with C and\/or E antigen positivity (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200926). RhD, RhCE and Duffy phenotyping was performed, followed by\n                      <jats:italic>RHD<\/jats:italic>\n                      ,\n                      <jats:italic>RHCE<\/jats:italic>\n                      and\n                      <jats:italic>FY<\/jats:italic>\n                      genotyping using multiplex polymerase chain reaction with sequence\u2010specific primers (PCR, PCR\u2010SSP) and real\u2010time PCR. Samples unresolved by targeted assays underwent sequencing.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among weak D donors, 88% carried known\n                      <jats:italic>RHD<\/jats:italic>\n                      variants, with weak D types 1, 2 and 3 accounting for 67% of cases. Partial D alleles such as\n                      <jats:italic>DAR<\/jats:italic>\n                      ,\n                      <jats:italic>DAU4<\/jats:italic>\n                      and weak partial 11 were identified, particularly among donors with Fy(a\u2212b\u2212) and Fy(a+b\u2212) phenotypes, often associated with\n                      <jats:italic>RHCE*<\/jats:italic>\n                      733G. In the D\u2010negative group, 50% of samples harboured non\u2010functional or hybrid\n                      <jats:italic>RHD<\/jats:italic>\n                      alleles, including\n                      <jats:italic>RHD*<\/jats:italic>\n                      03N.01\/\n                      <jats:italic>RHD*<\/jats:italic>\n                      08N.01 and\n                      <jats:italic>RHD*<\/jats:italic>\n                      08N.01\/\n                      <jats:italic>RHD*<\/jats:italic>\n                      01N.01, linked to the r's haplotype and\n                      <jats:italic>RHCE*<\/jats:italic>\n                      ceS allele.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This study reveals the wide spectrum of\n                      <jats:italic>RHD<\/jats:italic>\n                      variants in an admixed population and underscores the importance of integrating molecular genotyping and phenotype associations to improve transfusion safety and guide Rh immunoprophylaxis.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/vox.70283","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T14:04:25Z","timestamp":1778249065000},"page":"1210-1219","source":"Crossref","is-referenced-by-count":0,"title":["Molecular characterization of D variants in Brazilian blood donors and their association with\n                    <scp>RhCE<\/scp>\n                    and Duffy phenotypes"],"prefix":"10.1111","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-6434-1654","authenticated-orcid":false,"given":"Thamy C. S.","family":"Silva","sequence":"first","affiliation":[{"name":"Department of Clinical and Experimental Oncology Federal University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"},{"name":"Department of Pharmaceutical Sciences Federal University of S\u00e3o Paulo  Diadema Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcia R.","family":"Dezan","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Pr\u00f3\u2010Sangue  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sidneia","family":"Costa","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Oncology Federal University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz C.","family":"Girardo","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Oncology Federal University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno R.","family":"Cruz","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Oncology Federal University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Ziza","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Oncology Federal University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4642-8091","authenticated-orcid":false,"given":"Dante M.","family":"Langhi","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Oncology Federal University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 O.","family":"Bordin","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Oncology Federal University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilian","family":"Castilho","sequence":"additional","affiliation":[{"name":"Red Cell and Molecular Blood Group Laboratory Hemocentro\u2010UNICAMP  Campinas S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla L.","family":"Dinardo","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Oncology Federal University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"},{"name":"Funda\u00e7\u00e3o Pr\u00f3\u2010Sangue  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trim.2005.03.003"},{"key":"e_1_2_9_3_1","volume-title":"The blood group antigen factsbook","author":"Reid ME","year":"2012"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1516-84842005000200011"},{"key":"e_1_2_9_5_1","first-page":"93","article-title":"Molecular basis of the Duffy blood group system","volume":"16","author":"H\u00f6her G","year":"2018","journal-title":"Blood Transfus Trasfus Sangue"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transci.2019.08.018"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.2478\/immunohematology-2023-016"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcla.21489"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V95.1.12"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.2003.00313.x"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V93.1.385"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1309\/3XMF2NV5707TJE7X"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.2001.41010045.x"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.2002.00096.x"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2002-01-0229"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.12554"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.12413"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12967-019-02134-9"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjhh.2015.10.001"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2005.00631.x-i1"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.21307\/immunohematology-2020-040"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/tme.12309"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.4103\/0973-6247.115568"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.12409"},{"key":"e_1_2_9_25_1","article-title":"Effectiveness of strategies to screen for blood donors with RH variants in a mixed population","volume":"59","author":"Almeida FAA","year":"2020","journal-title":"Transfus Apher Sci Off J World Apher Assoc Off J Eur Soc Haemapheresis"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.12712"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3148.2011.01129.x"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.21307\/immunohematology-2019-168"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0017063"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.12179"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-03-490623"},{"key":"e_1_2_9_32_1","first-page":"405","article-title":"(C)ce(s) haplotype screening in Tunisian blood donors","volume":"12","author":"Moussa H","year":"2014","journal-title":"Blood Transfus Trasfus Sangue"},{"key":"e_1_2_9_33_1","first-page":"50","article-title":"The genetics of the Rhesus blood group system","volume":"5","author":"Flegel WA","year":"2007","journal-title":"Blood Transfus"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/tme.12944"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.12488"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2005.00586.x"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3148.2005.00638.x"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2007.01278.x"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.17132"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.13109"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.htct.2021.01.011"},{"key":"e_1_2_9_42_1","first-page":"s264","article-title":"Systematic RH genotyping and variant identification in French donors of African origin","volume":"12","author":"Kappler\u2010Gratias S","year":"2014","journal-title":"Blood Transfus"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2156-4-14"}],"container-title":["Vox Sanguinis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/vox.70283","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/vox.70283","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/vox.70283","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T01:51:32Z","timestamp":1786326692000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/vox.70283"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,8]]},"references-count":42,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1111\/vox.70283"],"URL":"https:\/\/doi.org\/10.1111\/vox.70283","archive":["Portico"],"relation":{},"ISSN":["0042-9007","1423-0410"],"issn-type":[{"value":"0042-9007","type":"print"},{"value":"1423-0410","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,8]]}}}