{"doi":"10.2450/bloodtransfus.1053","title":"Molecular characterization of variant D antigen expression among 56,445 blood donors in East India.","abstract":"BACKGROUND: Transfusion of red cells from RhD-positive donors to recipients lacking all or some epitopes of the D antigen can lead to the development of anti-D, potentially resulting in hemolytic transfusion reactions. Over 500 RHD alleles affect the qualitative or quantitative expression of the D antigen. There are huge differences in their prevalence among populations. Despite the distinct genetic diversity across multiple sub-populations in India, the prevalence of RHD alleles in the East Indian region has remained unknown. MATERIAL AND METHODS: Standard hemagglutination tests were performed, along with molecular techniques to determine the nucleotide sequence of the RHD gene. RESULTS: Over 3 years, 56,445 blood donors were tested at the Tata Medical Center, Kolkata by serology. We found 23 samples with D-discrepant test results in immediate spin anti-D technique (0.04%), all of them were C+c+. Variant RHD alleles were identified in 15 samples (15/23, 65.2%). The Indian-type weak D (RHD*01W.150) was the most common variant (30.4%, No.=7), occurring in 1 in 8,063 blood donors in East India versus 1 in 729 blood donors in South India (p<0.001). Other identified variants included RHD*06.03.01 (No.=3), RHD*17.05 (No.=2), RHD*01.EL.37 (No.=2), and RHD*01W.96 (No.=1). The remaining 8 samples (8/23, 34.8%) carried the reference RHD allele (RHD*01.01). DISCUSSION: Our findings reveal a lower prevalence of Indian-type weak D in East India than South India, indicating region-specific genetic diversity. The high incidence of wild-type RHD allele with D-discrepancy in East India suggests a potentially novel molecular mechanism. While RHD*06.03.01 and RHD*17.05 have, the 3 others identified RHD alleles have not been associated with anti-D alloimmunization. We recommend D-negative transfusion for individuals with D-variants that have documented alloimmunization, and advocate to investigate the clinical significance of other D-variant alleles prevalent in East India, such as the Indian-type weak D.","journal":"PubMed","year":2025,"id":545454,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9517,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":387829,"name":"Kshitij Srivastava","orcid":"0000-0002-3658-0815","position":1,"is_corresponding":false},{"id":72270,"name":"Mercy Rophina","orcid":"0000-0003-0756-9112","position":2,"is_corresponding":false},{"id":245332,"name":"Vinod Scaria","orcid":"0000-0001-7644-7181","position":3,"is_corresponding":false},{"id":1436251,"name":"Yew‐Wah Liew","orcid":"0009-0004-3405-6771","position":4,"is_corresponding":false},{"id":1436720,"name":"Jenny Morrison","orcid":null,"position":5,"is_corresponding":false},{"id":1436252,"name":"Glenda Millard","orcid":"0000-0002-3809-9662","position":6,"is_corresponding":false},{"id":347479,"name":"Willy A. Flegel","orcid":"0000-0002-1631-7198","position":7,"is_corresponding":false},{"id":1436250,"name":"Suvro Sankha Datta","orcid":"0000-0003-2094-6429","position":0,"is_corresponding":true}],"reference_count":0,"raw_metadata":null,"created_at":"2026-07-19T02:53:23.001995Z","pmid":"40681466","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}