1. Lesson 4-7
Rh Typing

2. Rh Blood Group System Discovered in 1940s
Second most important group after
ABO
See Table 4-15
Complex system, over 50 antigens
D is most important Ag in group

3. Rh Blood Group System Rh antigens only on RBCs
No naturally occurring Ab
~ 85% of U.S. population is D+
See Table 4-16

4. Detection of Rh D Slide test Tube test Gel test
Agglutination is positive result
Only test for D antigen
Patient blood + anti-D
D positive cells agglutinate with anti-D
Tube test
Gel test

5. Detection of Rh Antigens
Weak D antigen
Reacts weakly in slide test
Further testing required
Antiglobulin test
Blood considered D positive
Rh antigens other than D
C, c, E, and e most important after D

6. Rh Antibodies Do not occur naturally
Produced after exposure to Rh antigen
Transfusion
Pregnancy

7. Rh Antibodies IgG class Importance of Rh typing
Must be done before transfusion
Identifies risk of HDN

8. Nomenclature Three nomenclatures See Table 4-17 Fisher-Race Weiner
Rosenfield

9. Inheritance Rh antigens are products of codominant genes RHD gene
RHCE gene: 4 alleles
See Table 4-18

10. Hemolytic Disease of Newborn
Causes
Symptoms and consequences
Prevention
Identify at-risk mothers by Rh typing
Administer Rh immune globulin (RhIG)

11. Rh Typing Procedures Safety precautions Quality assessment
Slide typing
Whole blood + anti-D
Heated light box
Agglutination is positive result

12. Rh Typing Procedures Tube typing Preferred method Forward typing only
Patient cells + anti-D
Grade agglutination

13. Rh Typing Procedures Interpreting results Gel typing
Agglutination is positive result
Confirm negative result with weak D test
Any degree of agglutination is considered
D positive
See Table 4-19
Gel typing
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