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The page below is a sample from the LabCE course Overview Of Major Antigens of the Rh Blood Group System. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Rh Antigens of Clinical Importance

Since D is the most immunogenic antigen in the Rh system, testing for the presence or absence of the antigen is routinely required. Immunogenicity is the ability of an antigen to stimulate an immune response. It has been shown that exposure to as little as 0.1 mL of Rh-positive red cells can stimulate production of anti-D in an Rh-negative individual. c, E, C, and e antigens - in that order - have all been found to be highly capable of eliciting an immune response. During the course of a workup for identification of an immune antibody, for example, the patient's red cells may be tested for all five antigens in the Rh system. In clinical situations such as sickle cell disease or thalassemia requiring ongoing transfusion of red cells, some institutions proactively match the patient and donor for Rh and K phenotypes to prevent the formation of multiple antibodies.
Harmening, D: Modern Blood Banking and Transfusion Practices, 6thed, FA Davis, Philadelphia, PA, 2012, p 161.
Blaney, KD and Howard, PR: Basic & Applied Concepts of Blood Banking and Transfusion Practices, 3rd ed. Elsevier, St. Louis, MO, 2013, p 112.
Fung, MK, Eder, AF, Spitalnik, SL, Westhoff, CM (eds): Technical Manual, 19th ed. AABB, Bethesda, MD, 2017, p 310.