Relevance and costs of RHD genotyping in women with a weak D phenotype
| Autor: | Julia Gouvitsos, Elisabeth Durieux-Roussel, Caroline Izard, Laurine Laget, Jacques Chiaroni, Isabelle Dettori, V. Ferrera-Tourenc |
|---|---|
| Přispěvatelé: | Etablissement Français du Sang - Alpes-Méditerranée (EFS - Alpes-Méditerranée), Etablissement Français du Sang, Établissement Français du Sang Alpes-Méditerranée (EFS Alpes-Méditerranée), Anthropologie bio-culturelle, Droit, Ethique et Santé (ADES), Aix Marseille Université (AMU)-EFS ALPES MEDITERRANEE-Centre National de la Recherche Scientifique (CNRS) |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Genotype Genotyping Techniques Rho(D) Immune Globulin [SDV]Life Sciences [q-bio] Clinical Biochemistry 030204 cardiovascular system & hematology Serology Young Adult 03 medical and health sciences 0302 clinical medicine Pregnancy medicine Humans Genotyping ComputingMilieux_MISCELLANEOUS Rh-Hr Blood-Group System Obstetrics business.industry Biochemistry (medical) Health Care Costs Hematology Middle Aged medicine.disease Phenotype Cohort RBC antibody detection Weak D phenotype Female France business 030215 immunology |
| Zdroj: | Transfusion Clinique et Biologique Transfusion Clinique et Biologique, 2018, ⟨10.1016/j.tracli.2018.05.001⟩ Transfusion Clinique et Biologique, Elsevier, 2018, ⟨10.1016/j.tracli.2018.05.001⟩ |
| ISSN: | 1246-7820 1953-8022 |
| DOI: | 10.1016/j.tracli.2018.05.001⟩ |
| Popis: | Objectives For pregnant women, the serologic test results of D antigen will determine the frequency of RBC antibody detection as well as the indication for RhIG prophylaxis. RHD genotyping is the only method that may provide clear guidance on prophylaxis for women with a weak D phenotype. This analysis evaluated the economical implications of using RHD genotyping to guide RhIG prophylaxis among pregnant women with a serological weak D phenotype. Methods We compared the costs of 2 strategies in a cohort of 273 women with weak D phenotype. In the first strategy, we did not perform genotyping and all women with weak D phenotypes were treated as if they were D−, thus considered to be a risk of RhD alloimmunization. These women all received the prophylactic follow up. In the second strategy, RHD genotyping was performed on all women with a serologic weak D phenotype. Then, the follow-up will be determined by phenotype deduced from genotype. Results On the studied cohort, the additional expense occurred by genotyping is 26,536 €. RHD Genotyping has highlighted 162 weak D Type 1, 2 3, that could safely be managed as D+ and 111 partial D to consider as D−. By comparing the 2 strategies, the savings generated by genotyping the patients of our cohort are € 12,046 for the follow up of one pregnancy. Knowing that in France, a woman has on average 2 pregnancies and that the genotyping is carried out only once, the savings generated for the following pregnancies would be € 38,581. Conclusions Performing RHD genotyping for pregnant women with a weak D phenotype enables to clearly identify weak D type 1, 2 or 3 from the other variants at risk of alloimmunization. This analysis generates savings in terms of follow-up schedule of pregnant women and RhIG prophylaxis. It also allows saving of D− products for patient with a weak D type 1, 2 or 3 in case of a transfusion need. |
| Databáze: | OpenAIRE |
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