หมู่เลือดอาร์เอชเดลชนิดเอเชีย: ความชุก ความสำคัญทางคลินิก และการให้เลือดอย่างปลอดภัย

Chirapond  Chonanant; Nattaphol  Prakobkaew; Worapong Khaodee; Surachat Buddhisa

Authors

Chirapond Chonanant Department of Medical Technology, Faculty of Allied Health Sciences, Burapha University, Amphoe Muang Chonburi, Thailand
Nattaphol Prakobkaew Department of Medical Technology, Faculty of Allied Health Sciences, Burapha University, Chonburi, Thailand
Worapong Khaodee Department of Medical Technology, Faculty of Allied Health Sciences, Burapha University, Chonburi, Thailand
Surachat Buddhisa Department of Medical Technology, Faculty of Allied Health Sciences, Burapha University, Chonburi, Thailand

Keywords:

RhDel, Asian-type DEL, anti-D

Abstract

Introduction: RhDel is a variant of the RhD-positive blood group, with an extremely low D antigen expression which cannot be detected by standard serological methods, resulting in its misclassification as RhD-negative. Further specialized techniques such as adsorption-elution or
molecular biological testing are required to distinguish RhDel from true RhD-negative individuals. Asian-type DEL is highly prevalent among RhD-negative individuals in Asian populations, and can induce anti-D alloimmunization in truly RhD-negative recipients, potentially leading to hemolytic transfusion reactions (HTR) and hemolytic disease of the fetus and newborn (HDFN). Therefore, understanding the prevalence, clinical significance, and means of accurate laboratory identification of Asian-type DEL is essential for safe blood transfusion practices.

Objective: To review and analyze data on the prevalence, clinical significance, and safe transfusion practices of the Asian-type DEL blood group.

Methods: A systematic literature review and analysis of research articles related to the Asiantype DEL from PubMed and Google Scholar, covering publications from 2000 to 2025.

Results: The Asian-type DEL has a high prevalence among RhD-negative individuals in East Asia and Southeast Asia, including Thailand. Clinical evidence demonstrates that individuals with Asian-type DEL do not develop anti-D after receiving a transfusion with RhD-positive blood, or from carrying RhD-positive fetuses. In contrast, blood donated from individuals with the Asiantype DEL has been reported to stimulate anti-D production in RhD-negative patients.

Conclusion: The Asian-type DEL is a crucial consideration for transfusion management in Asia. Molecular biological techniques must be combined with standard serological methods to ensure an accurate identification. Patients with Asian-type DEL can safely be transfused with RhD-positive blood, while donated blood from Asian-type DEL individuals should be managed as RhD-positive and restricted to RhD-positive recipients only.

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