Joe Chaffin
Malcolm Needson May 13, 2016 at 9:41 am
Brilliant, as ever. Just a couple of things. It would, perhaps, have been nice to mention the fact that the two gene theory was first put forward by Dr Patricia Tippett, who is still well and as sharp as a needle, despite having retired many years ago now. I have a recent photograph of her, but cannot attach it here. I will email it to you, if you could provide an email address.
The other thing is, and I may be completely wrong here, I always thought that, when the nomenclature RHCE*ce (I know, it should be italicised, but I can’t do it here!) is used, the “*” meant that the genotype had actually been “proved” by molecular techniques, rather than just by serological techniques. As I say, I may be wrong – it wouldn’t be the first time, and I have very grave doubts that it will not be the last time!
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joechaffinon May 13, 2016 at 10:36 am
Malcolm, thanks for the reminder about Dr. Tippett. You are right; she deserves mention, and I have updated the post to reflect that. As for the nomenclature stuff, honestly, I’m not remotely a geneticist, and the details of that issue go far more into “the deep end of the pool” than is necessary for this post, I think. I’m sure that you are right; I defer to your expertise, but don’t think it will matter to most people learning about this! Thanks, as always, for your kind comments.
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Matt Hukillon August 10, 2018 at 1:44 pm
I was struggling with this same thing until I read this comment. You cleared it up for me, thank you!
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MONA TALAATon January 25, 2019 at 4:21 am
thank u very much please we need a video about SCT
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Ghazia Raheemon October 3, 2021 at 6:58 pm
Thank you so so so much!
Finally got it.
May GOD bless you!Reply
lavender1216on November 30, 2016 at 8:25 am
Hi! I’ve been studying for the exam and your website is very helpful.
On the table showing the offspring’s phenotype and genotype, if R1 was inherited , there shouldn’t be an “E” ?Reply
joechaffinon November 30, 2016 at 12:06 pm
Remember, the “R1” haplotype designation means that the person has inherited two alleles: RHD and RHCe. That means that combination gives a D antigen, a C antigen, and an e antigen (NOT an E). I think that the table you are referring to shows the possibilities with an R1R0 and an rr combination. None of those haplotypes would impart an E antigen. I hope that makes sense! Joe
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Jay Con September 19, 2020 at 10:10 pm
Joe. I know it’s a couple years late but the table showing the haplotypes with an R1R0 and an rr combination actually shows an E antigen in all four offspring, as well as a C antigen for the R0r offspring. I believe that is what lavender1216 was trying to ask.
BTW…love this site!!Reply
Joe Chaffinon September 22, 2020 at 1:27 pm
I don’t THINK the table shows that, Jay! There is a “-” after the E in all four places, and for R0r, the C also has a “-” after it, indicating the LACK of that antigen.
-JoeReply
Kitty Son December 29, 2016 at 5:03 am
After 25 years of working in my lab, and only performing the most basic of blood banking, the powers that be want the staff to start performing panels. Yikes! Your site has helped me refresh those long ago forgotten techniques. Thanks for being there!
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joechaffinon December 29, 2016 at 9:21 am
Kitty, I’m glad to be of help to you! What you are describing is not uncommon in U.S. labs today, as fewer and fewer qualified staff are available, it seems. I wish you the best as you navigate tricky waters. The content on this site, in part, is designed for people like you who are learning (or re-learning in your case) the field.
JoeReply
carleneon April 25, 2017 at 5:57 pm
I have a child who has liver cancer and has been old she has blood that can not be typed because it reacts as all known types. I am trying to understand how is this possible? They cant type her blood by standard tests.
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Joeon May 4, 2017 at 7:09 pm
Carlene, I’m so sorry to read about your child’s liver cancer. Unfortunately, there is no way to evaluate your situation without more information, and I can’t do internet consultations. Please talk to local transfusion medicine experts in your area! Most every hospital can find someone who has enough experience and knowledge to discuss your child’s case intelligently (often, that will be the doctor overseeing your blood supplier, but in some hospitals, the expert may actually already work there). I wish you and your family the very best.
-JoeReply
Vanessaon June 2, 2017 at 10:37 pm
I am currently preparing for my ASCP exam. I just want you to know how grateful I am for your site. It is very helpful. Everyone in my review class checks out your blogs and videos. You are one famous guy in our class ! Thank you sooooooooo much again xo
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Joeon June 3, 2017 at 5:50 pm
Thanks, Vanessa! That’s very nice of you to say. I’m happy to help.
-JoeReply
Mariamon June 19, 2017 at 2:42 pm
These are very detailed and interesting information. I’m a medical laboratory science student and these information helped a lot, thank you very much .
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mlsstudenton August 12, 2017 at 11:03 am
I was understanding fine after reading this blog..and then I come across this question:
The Wiener nomenclature for the E antigen is:
A. hr´
B. hrv´
C. rh˝
D. Rh0Lost again.. Please help..where did the little “rh” and “hr”s come from?! UGH!
Sincerely,Frustrated Student
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Joe Chaffinon August 13, 2017 at 12:27 am
Don’t be frustrated! You have run across some very archaic terminology; in fact, the question is asking you to know Wiener’s names for the five Rh antigens. As the post mentioned, The names for the five main Rh antigens in the Fisher-Race terminology are D, C, E, c, and e. Wiener called them something different (and a LOT more confusing!). Here’s how they correspond:
- D = Rh0
- C = rh’
- E = rh”
- c = hr’
- e = hr”
Fortunately, those terms are rarely used any more, as pretty much everyone uses the Fisher-Race, or “DCE” terminology. Wiener’s original names only appear in old articles, conversations with blood bankers who have been around for a long time, and occasionally, on exams and practice exams, as it seems you have experienced! You can clearly see the pattern above (rh means a capital C or E while hr means a small c or e; ‘ means C or c, ” means E or e), so it shouldn’t be terrible to spend a minute to remember these before an exam. In real life, though, you will rarely see or hear them!
-JoeReply
Gerard Narvaezon March 26, 2021 at 7:23 pm
thanks joe
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Temon October 16, 2017 at 11:11 am
thanks for your great explanation. can i use this for my students? thank you again
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Joe Chaffinon October 16, 2017 at 11:23 am
Of course! This site is designed to be a help to those teaching blood banking and transfusion medicine. I only ask that you attribute appropriately and avoid changing my words.
-JoeReply
Jennifer L. Stroudon April 8, 2018 at 7:46 am
I was told once I had 0+ with a genotype of r2r2 (not R2R2) and rare. I was reading this article to try to figure this out, but over my knowledge base here and not really understanding in laymen’s terms.
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Joe Chaffinon April 9, 2018 at 12:47 am
Jennifer, send me an email through the comment page and I’ll be happy to try to help. I can’t do medical consultation over the internet, of course, but I’ll do what I can. Thanks for writing!
-JoeReply
Judyon April 25, 2018 at 5:46 pm
I got it! I was struggling for days to memorize the Rh nomenclature and now I have a good grasp of this material. I am preparing to take my MT certification next week and this is just helpful. Thank you.
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Joe Chaffinon April 26, 2018 at 12:59 am
I’m so glad to help you, Judy! Best of luck on your exam!
-JoeReply
Heather behmon March 4, 2019 at 8:35 am
Hi,
I am 52 years and old and 15 years ago I delivered my son 5 weeks early due to escalating antibodies. Post delivery (my son with bad jaundice, but otherwise healthy) the below information was explained to me by the hospital’s hematologist. He said my blood combination was rare. I have since been diagnosed with an autoimmune disorder – rheumatologist says my tests look like I have Lupus, but I’ve had no symptoms in the 13 years since it was discovered after my delivery.
Anti C
Anti c
Anti EI was told I need:
c-E bloodQuestion, is this blood difficult to find? Should I be stocking up on my own blood, God forbid, I ever need it? Should my two children be tested for similar blood related issues?
Many thanks,
HeatherReply
Joe Chaffinon March 4, 2019 at 11:40 am
Heather, thanks for reading the blog and for your question. Unfortunately, there’s a decent amount of detail in the response, and I can’t give you medical advice through this site. Here’s what I can say: Anyone with antibodies in their blood against what we call “antigens” on red blood cells that are not in the ABO system and the main Rh antigen (we call that one “D”) should clearly understand what that means to them and their future possible transfusion needs. The only way to do that, in my view, is to have a conversation with someone who can be involved in your care, such as a personal physician. Now, you may have to be persistent with this, as it’s very possible that those antibodies may have gotten weaker (or even disappeared over time), so your testing may appear different now than it did 15 years ago. Also, many healthcare providers don’t have a lot of experience dealing with these types of antibodies, and it may require a discussion with a hematologist or Transfusion Medicine specialist at the hospital where you were tested before to sort it all out. In the end, though, you should have someone review the exact antibodies you had then and have now, and be able to understand exactly what it means. I encourage you to be persistent. If worse comes to worse, your local blood donor center will generally have a physician overseeing things that you could discuss this issue with. I wish you the best.
-JoeReply
Valerieon May 31, 2018 at 5:55 pm
thank you so much for clearing this up!! i am now enrolled in an SBB program and this helped ALOT! will be visited this blog and your others to help clear the murky waters i’m in now!
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Nadaon December 12, 2018 at 3:08 pm
Hello, I donated blood today and the nurse put a sticker on the bag to say it was suitable for neonatal babies. I’m O+ and apparently R1R1 – she said look it up on the internet – which I have done and found you – but nothing I have read tells me why my blood is suitable for newborn babies. I’d love to know why – just curious. TBH I don’t care who gets my blood as long as it helps them.
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Joe Chaffinon December 20, 2018 at 10:52 pm
Hi Nada! Sorry it took me awhile to respond. I can’t say for sure why the nurse said that, but it is most likely due to the combination of you being blood group O (which means your blood can go to any other blood type: A, B, or AB, as well as others that are group O) and being negative for a virus called “cytomegalovirus (CMV).” Again, I can’t say that for sure, but that is most likely. CMV is a big deal for little babies, so we try to give them blood that is less likely to give them that infection. By the way, since you are O positive instead of O negative, your blood might not be used for all babies, but it would certainly be useful for babies who are Rh positive like you. Most importantly, thank you so much for donating! We need blood every day, and I’m sure your donation will be used in the best possible way.
-JoeReply
Susan greenon December 22, 2018 at 4:52 am
I have a card from the hospital over 35 years ago saying I am A r’r blood group. I was told it is rare that I cannot give blood as I had anti D after giving birth.
Is this blood group correct as I cannot see anything on lineReply
Joe Chaffinon December 24, 2018 at 3:07 am
Susan, this response will not be adequate at all, but here’s a quick attempt:
- I’m not positive you were saying that you were told you were “GROUP A, with r’r” or if the “A” just happened to be capitalized and you are saying your blood group is r’r
- Either way, the bottom line is that someone who carries r’r is what is commonly called “Rh negative.” That is what r’r means; that person is Rh negative (a somewhat unusual, but not really “rare” type of Rh negative, but Rh negative all the same). Someone like you would just say your blood type as “A negative” (or O negative or B negative or AB negative, depending on whether I misunderstood what you wrote above)
- Someone like you who is Rh negative may develop antibodies against the main Rh protein, called “D” after being exposed to blood from someone who is Rh positive. In the past, pregnancy was the most common way this happened, by far
- Indeed it is true that people what have made anti-D are not typically eligible to be regular blood donors. There are a lot of reasons for that, and it isn’t universally true, but that is the most common answer
For more information, you should speak to a local blood bank director in a hospital or blood center near you. Only they could speak more directly to your circ*mstances. I wish you the best!
-JoeReply
Gerryon May 22, 2019 at 2:03 pm
I had anti-D and am a blood donor in the UK so women who want to donate blood, but have assumed they can’t, check it out with your local donation organisation.
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Gerry Matthewson July 21, 2022 at 5:48 pm
I am an Rh negative UK female donor.
I think there may be a confusion here between women who have developed antibodies to the RhD antigen and us women who have had a jab against developing such antibodies.
Having anti-D antibodies means can’t continue to donate, (e.g.,https://nibts.hscni.net/spotlight-christinas-story/) whereas having anti-D jab/s (RhoGAMin US), to prevent the formation of antibodies, can donate.
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Zarreen Alion January 5, 2019 at 5:57 am
I love you sir !!! I can’t tell you how helpful it was.You are a savage.I watched alot of videos but still got nothing and this explaination just solved everything.It was my 1st time on your website but it won’t be the last time I believe.
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saadat shahon April 2, 2019 at 7:29 am
i was just going through Rh blood group system and find ur blog sir…this was really very helpful..thanks for explaining beautifully.good enuff to memorize now.
will read more of your blogs.keep it up…Reply
May Thu Aungon April 8, 2019 at 8:37 am
Sei un genio!
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Gurbaksh Singh Kandaon April 13, 2019 at 6:32 am
Excellent work Joe. I find all the information here really handy and informative.
Keep up the good work.Regards
GurbakshReply
Janet Sharunon April 15, 2019 at 8:26 am
We had genotyping done on a WAIHA who’s Rh Control and Anti-D were both 4+ (invalid!). Genotype we were given is RHCE*cd, RHCE*cE ….. does this give us answer to wether he is Rh Positive or Negative?
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Joe Chaffinon April 16, 2019 at 9:38 am
Unfortunately, it appears there’s a typo in that genotype, Sharon! I’m not familiar with “RHCE*cd” and I asked a good friend who is an Rh genetics expert as well, and that person feels the same. It seems more likely that was intended to be “RHCE*ce” which would mean the answer to your question is that those results do NOT tell you whether the person is D-positive, D-negative, or has a D variant. You need specific genetic testing on the RHD gene to get that answer. The results you have quoted are for the OTHER Rh gene, RHCE.
-JoeReply
Dannieleon June 5, 2019 at 11:28 pm
Hi Joe,
I’m a medical laboratory student and as much as I have a passion for blood banking and transfusion science, sometimes the content can get a little tricky! But your site has definitely helped me navigate me through any concerns I have had. Thanks so much for your dedication for teaching! It is obviously doing so many people a lot of good.
Danni
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Joe Chaffinon June 6, 2019 at 9:47 am
I’m honored that you feel that way, Danni, and grateful that you took the time to write. Best wishes in your studies!
-JoeReply
Valaon June 10, 2019 at 6:53 am
Thank you so much for taking the time to explain this in such an easy-to-understand way! As a biochemist currently doing some background training in the transfusion lab, your blog has been an absolute lifesaver whilst navigating this new field!
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Joe Chaffinon June 26, 2019 at 2:39 pm
Vala, you are most welcome. I’m honored to help you!
-JoeReply
CH Tanon August 26, 2019 at 11:26 pm
Thanks for your informative post,
this made my immunohaematology lectures for MLT students much much more easier to understand…Reply
Indigo Carrollon October 25, 2019 at 1:05 pm
THANK YOU SO MUCH. This has really helped me break down how to remember Fisher-Race Terminology!
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Sandyon October 26, 2019 at 5:11 am
Could you please explain how a sickle protocol unit of blood is negative for little e?
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Joe Chaffinon October 26, 2019 at 10:26 am
Not quite sure what you are asking me, Sandy. Please send me a direct email by using BBGuy.org/ask, and I’ll try to help if I can.
-JoeReply
Maggie Jane Vin Zanton January 21, 2020 at 12:58 pm
hey Joe,
Interesting read. I am curious if you could help me understand something. “A Little Back Story.” I have known I was A+ since my first child in 1991 but in 2007 I was in a car accident and lost a lot of blood so I had to receive blood. However, for some reason, my body was not accepting the A+ blood and they noticed that my levels were not changing. They ran several tests but could not figure out the problem.
After sending my blood to a specialist I was told that I have to receive A+ blood with a capital A antigen at a certain place in the chart the doctor gave me (on the 13th spot if I remember correctly. No worries I have given copies to all my medical professionals just in case).
I have searched for other instances for this but nowhere have I found anything similar. It was made very clear to me that this is something I need to make sure I give my medical professionals if I ever have surgeries but it always seems to stump some of them.
I was just wondering If you have ever heard of this before. I can never find information on it and want to know more. I always read about the RH stuff but none of it even covers what I was told and I never see references to a Capital A antigen.
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Joe Chaffinon January 23, 2020 at 12:05 am
Maggie, it’s not completely clear what you are describing to me, and I really can’t do medical consultation through the site anyway. The most important thing is that those records you mention are known to those taking care of you. I’m sorry I can’t help you more, but the terminology can be confusing, and seeing exactly what is written is the only way to be sure. I wish you the very best.
-JoeReply
Adion February 22, 2020 at 8:07 pm
Hi Joe:
Have ever experienced a different in the reaction strength of Anti-c (little c) and Anti E (big E) with R2R2 vs rr. We are seeing +2 reactivity with rr and negative with R2R2.
we know that R2R2 had the highest number of D antigens.Thanks
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Ed S.on April 13, 2020 at 4:13 am
Hi there,
Just want a bit of understanding of my supposedly strange blood combination when in comparison to my ethnicity.
I’m Lithuanian (WHITE), both parents Lithuanian. However, my blood is B+ (most common amongst Asian) with a positive R0 Subtype (most commonly found in African Americans).
Any idea what I could research to find out a bit more? Thanks.
Ps I’m aware that Lithuanian tribes emerged from Indo/Europe/
Thanks.
EdReply
Cathon October 2, 2020 at 2:04 pm
Hi Joe,
I am currently reviewing for my SBB and what would the probability of having an Rh negative kid if there are more than 8 offspings? I’m just curious because the Punnet square only show like the probability to just 4 children. What if there are more? Can you help me understand like how to do the inheritance pattern for mom that has more than 6 or 8 children? Thank you!
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Joe Chaffinon October 18, 2020 at 12:06 pm
Cath, the possibilities there are the only possibilities from those two parents, no matter how many kids there are in the family (by simple Mendelian genetics, anyway). In that example, each child born, whether they are the first-born or the eight-born or the eleventh-born, has a 50% chance of being R1r and a 50% chance of being R0r.
-JoeReply
Vicon March 8, 2021 at 7:51 pm
At risk of sounding very ignorant, what does it mean by R1wR1? How does it differ from R1R1?
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christopher reginald phillipson May 27, 2021 at 4:23 am
Can you tell me more specific my blood type Type B Rh DCE Neg
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Violeta Wilfredon December 3, 2021 at 1:23 am
Hi, I am trying to understand this better but I guess I can’t. I am a regular blood donor and I went to donate my blood this morning. The nurse told me that my phenotype R1RZ. I didn’t understand that but she said that my blood type is suitable for the Thalasemia patients.
Appreciate if you could explain further on this, in a layman term. I am a potential kidney donor for my daughter. She is a CKD stage 5 patient and she is O. The difference of our blood type will still allow us to do because the crossmatch test done is negative.
However, I still need further explanation from you on this.
Thank you very much.
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Jacqueline Mellison October 10, 2022 at 3:44 am
Hi, Prior to surgery and after a blood test, I was given a card to be carried by person with unusual blood group showing the following:
Cells: Rh (D) pos R1r
Serum: Anti – EI have been trying to find out my blood group and what the above means.
On occasion I have attempted to donate blood but was always asked “do you have a cold”. Then they would do a test and it would come back that all was well. I really don’t understand and my GP is probably not the person to advise. Can you help?Reply
Denise Beddowson June 27, 2023 at 10:07 pm
I know nothing about blood, but my late mother worked at a regional blood bank in UK and was a regular blood donor, until they found her blood had a particular factor – R2R2 – and they asked her not to donate unless called for. One day a taxi arrived at our house to whisk her off to give blood for Simon Bostick, the bone marrow transplant baby. I just wondered what the import of R2R2 is, whether I might have inherited it and, in that case, whether my blood (O-pos, like hers) might be useful to someone. I have donated blood but mine has not been tested for R2R2.
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revoon April 20, 2024 at 5:20 am
Greeting
Is there a table for rh phenotype compatiblity match? i.e compatiblity between different rh phenotype suppose ABO and D are same.Reply
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