Zur klinischen Bedeutung des Antigen D und seiner Varianten

Zusammenfassung

Varianten des Antigen D stellen infolge ihrer komplexen genetischen Grundlage für das immunhämatologische Labor und die transfundierenden bzw. behandelnden Ärzte eine Herausforderung dar. Schwache oder diskrepante serologische Bestimmungen des Antigen D sorgen für Unklarheiten in der Versorgung mit Erythrozytenpräparaten, aber auch bei der Gabe der Rh-Prophylaxe im Rahmen der Schwangerschaft. Die vorliegende Arbeit gibt, unter Berücksichtigung aktueller Empfehlungen und Richtlinien, einen Überblick zur klinischen Bedeutung der RhD-Varianten sowie zur Diagnostik, Transfusionspraxis und Mutterschaftsvorsorge. Neben den deutschen Richtlinien werden auch die schweizerischen Empfehlungen und österreichischen Standards berücksichtigt. Ein strukturiertes Vorgehen kann kostensparend und sollte aus ethischer Hinsicht geboten sein.

Abstract

The variants of the D antigen may pose a challenge for immunohematology laboratories and attending physicians, which is caused by the complex genetic basis. Weak or discrepant serologic typing results for the D antigen can lead to uncertainties with regard to both red blood cell transfusion and administration of RhIg prophylaxis during pregnancy. Using current recommendations and guidelines, the present article reviews the clinical implications of RhD variants for diagnostics, transfusion strategies and obstetrical care. The German regulations, the Swiss recommendations and the Austrian standards were considered. A defined strategy may reduce health care costs and should be implemented for ethical reasons.

Schlüsselwörter

Rhesus - Antigen D - RhD Varianten - Richtlinien - Hämotherapie

Key words

rhesus - D antigen - RhD variants - guidelines - hemotherapy

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