{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T16:46:10Z","timestamp":1791737170648,"version":"4.3.4"},"reference-count":56,"publisher":"Walter de Gruyter GmbH","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    The D\u2013\u2013 phenotype is an exceptionally rare Rh blood group phenotype characterized by expression of D in the complete absence of C, c, E, and e. Individuals with this phenotype are at risk of developing anti-Rh17 (anti-Hr\n                    <jats:sub>0<\/jats:sub>\n                    ), a clinically significant alloantibody that can severely complicate transfusion support and pregnancy management because compatible blood is exceptionally difficult to obtain. This review critically synthesizes the available published evidence regarding the D\u2013\u2013 phenotype and anti-Rh17 alloimmunization, integrating data from case reports, case series, family investigations, and molecular studies from different geographic regions. Current evidence regarding molecular mechanisms, immunohematologic character istics, serologic identification, transf usion management, pregnancy outcomes, and rare donor strategies is summarized, w ith emphasis on practical considerations relevant to transfusion medicine. Although the D\u2013\u2013 phenotype is exceptionally rare, early recognition, comprehensive immunohematologic evaluation, and proactive transfusion planning, including collaboration with rare donor programs, are essential for optimizing patient outcomes.\n                  <\/jats:p>","DOI":"10.2478\/immunohematology-2026-017","type":"journal-article","created":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T15:57:19Z","timestamp":1791734239000},"page":"102-112","source":"Crossref","is-referenced-by-count":0,"title":["D\u2013\u2013 phenotype and anti-Rh17 alloimmunization: a comprehensive review of identification and clinical management"],"prefix":"10.2478","volume":"42","author":[{"given":"Ehsan","family":"Shahverdi","sequence":"first","affiliation":[{"name":"1 Department of Oncology, Hematology and Blood Stem Cell Transplantation , Klinikum Osnabr\u00fcck , Osnabr\u00fcck , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mostafa","family":"Moghaddam","sequence":"additional","affiliation":[{"name":"2 Blood Transfusion Research Center , High Institute for Research and Education in Transfusion Medicine , Tehran , Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,10,11]]},"reference":[{"key":"2026101115571109833_j_immunohematology-2026-017_ref_001","doi-asserted-by":"crossref","unstructured":"Ramsey G. 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D\u2212\u2212 phenotype in a South Indian family: a multicentric approach to workup and management. Transfus Med 2025;35:297\u2013303.","DOI":"10.1111\/tme.13137"},{"key":"2026101115571109833_j_immunohematology-2026-017_ref_005","doi-asserted-by":"crossref","unstructured":"Shahverdi E, Moghaddam M, Abolghasemi H. First report of the rare Rh CE-depleted D\u2013 \u2013 phenotype in sixteen people of Iranian origin. Vox Sang 2019;114:256\u201361.","DOI":"10.1111\/vox.12738"},{"key":"2026101115571109833_j_immunohematology-2026-017_ref_006","unstructured":"Salamat N, Bhatti FA, Hussain A, Ziaullah A. Anti-Rh17 (anti-Hr0): a rare diagnostic and management problem. J Pakistan Med Assoc 2004;54:215\u20138."},{"key":"2026101115571109833_j_immunohematology-2026-017_ref_007","doi-asserted-by":"crossref","unstructured":"Augustine M, Parulekar A, Amoncar S, Mallya M. A case of anti-Rh17 (anti-Hr0) antibody in D\u2013\u2013 phenotype, a rare alloimmunization complicating transfusion management. 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