Overview Of Major Antigens of the Rh Blood Group System (by LabCE)

2 P.A.C.E. contact hour(s)

(based on 732 customer ratings)

Author: Pamela Inglish, MT (ASCP)SBB
Reviewers: Jessica M. Mantini, MS, MLS(ASCP)CM; Suzanne H. Butch, MA, MLS(ASCP)CM

Course provided by LabCE.

This course aims to provide the learner with an overview of the Rh blood group system, to review the unique characteristics of the antigens and antibodies of the system, to describe the naming conventions associated with the system, and to stimulate an appreciation for the complexities of the Rh system. The content provided is written with the assumption that the learner has a basic understanding of immunohematology and the ABO blood group system prior to taking this course.

See more courses in: Blood Banking / Immunohematology

Continuing Education Credits

P.A.C.E.® Contact Hours (acceptable for AMT, ASCP, and state recertification): 2 hour(s)
Course number 578-044-21, approved through 8/31/2023
Florida Board of Clinical Laboratory Personnel Credit Hours - General (Blood Banking / Immunohematology): 2 hour(s)
Course number 20-877208, approved through 8/31/2023


  • Recall the five major antigens of the Rh blood group system.
  • Describe and compare several terminologies/nomenclature conventions commonly used when discussing the Rh blood group system.
  • List the characteristics of the Rh blood group system, including basic biochemical and molecular composition as well as chromosome location and inheritance.
  • Describe four mechanisms that may result in weakened expression of the D antigen.
  • List characteristics of antibodies commonly encountered in the Rh blood group system, phase of reactivity, ability to cross the placenta, and effect of enzyme treatment during testing.

Customer Ratings

(based on 732 customer ratings)

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Course Outline

  • Overview of Rh
      • Introduction to the Rh System
      • History of Rh and association with LW
    • Practice questions
    • Genetics/biochemistry
        • Genes of the Rh System
        • Biochemical and Functional Characteristics of Rh
    • Nomenclature or terminology and inheritance in the Rh system
        • Terminology
        • Fisher-Race DCE Terminology
        • Haplotype prevalence (%) in Fisher-Race terminology
        • Wiener Rh-Hr Terminology
        • Fisher-Race and Wiener Terminology Road-map
        • Rosenfield Alphanumeric Terminology
        • ISBT Numeric Terminology
      • Practice questions
      • Rh system antigens and several important genetic alterations
          • Rh Antigens of Clinical Importance
          • Alterations in D Antigen Expression
          • Four Mechanisms of Weakened Expression of the D Antigen
          • Mechanism 1: C in trans to RHD
          • Mechanism 2: Weak D
          • Mechanism 3: Partial D
          • Mechanism 4: Del
          • Deletion, null and mod Phenotypes in the Rh System
          • Inheritance of the Rhnull and Rhmod Phenotypes
          • Other Unusual Phenotypes and Rare Alleles in the Rh System
        • Practice questions
        • Characteristics of Rh system antibodies
            • Characteristics of Rh Antibodies
            • Screening the Intended Recipient for Alloantibodies, Including Those in the Rh System
        • Laboratory testing for Rh system antigens and antibodies
            • Reagents For Use In Rh Typing
            • False-Positive Reactions With Rh Typing Reagents
            • False-Negative Reactions With Rh Typing Reagents
            • Rh Testing For Blood Donors and Labeling Blood Products
          • Practice questions
          • Clinical considerations related to the Rh system
              • Hemolytic Disease of the Fetus and Newborn (HDFN)
              • Hemolytic Transfusion Reaction (HTR)
              • Special Considerations for Chronically or Multiply Transfused Patients
              • Clinical Significance of Rhnull and Rhmod
            • Practice questions
            • Case study
                • Rh Case Study
                • Discussion of Rh Case Study
                • Rh Case Study, Further Testing
                • Rh Case Study, ID Panel crossout
                • Further Discussion of Rh Case Study
            • References
                • References

            Additional Information

            Level of Instruction: Intermediate 

            Intended audience: Medical laboratory scientists, medical technologists, and technicians. This course is also appropriate for medical laboratory science students and pathology residents.

            Author information:  Pamela Inglish, MT (ASCP)SBB has 30+ years of experience in medical laboratory sciences having completed training at the Medical College of Virginia/Virginia Commonwealth University. Subsequently, she obtained certification as a Specialist in Blood Banking through AABB/ASCP. For the majority of her career, Ms. Inglish held positions of responsibility in hospital transfusion services, blood centers, and clinical stem cell transplant processing laboratories and has also sold clinical lab diagnostic equipment and reagents. In her most recent position at the University of Cincinnati/Hoxworth Blood Center, she was director of quality assurance and education and served as an adjunct instructor.

            Reviewer information: Jessica M. Mantini, MS, MLS(ASCP)CM, is a clinical instructor of Immunohematology at the Ohio State University School of Allied Medical Professions and the Program Director for the Medical Laboratory Science Division. She holds an MS in Allied Health Management from Ohio State University.

            Reviewer information: Suzanne H. Butch, MA, MLS(ASCP)CM, SBB, DLM is currently working on special projects for the Department of Pathology at Michigan Medicine in Ann Arbor, Michigan. She formerly worked in Quality Assurance in the Department of Pathology and as the Administrative Manager for Healthcare, Blood Bank & Transfusion Service at the University of Michigan Hospitals and Health Centers in Ann Arbor, Michigan. She holds a Bachelors in Medical Technology from the University of Michigan, a Masters Degree in Management and Supervision from Central Michigan University, and Certifications as a Specialist in Blood Bank, as a Quality Audit and as a Diplomate in Laboratory Medicine. 

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