Hemolytic Disease of the Fetus and Newborn (HDFN) is not just a diagnosis from the history books! It still happens, and all involved must respond quickly. Dr. Greg Denomme guides us to better HDFN understanding and management.

Dr. Greg Denomme

Dr. Greg Denomme

In the distant past, far too many babies died because we did not understand the basic principles of what we now call “hemolytic disease of the fetus and newborn” (“HDFN” for short). Once researchers outlined the most common mechanism (anti-D formation in an Rh-negative mother impacting future D-positive babies) and the intervention to prevent its occurrence (injection of Rh Immune Globulin to prevent anti-D formation in the mother), the incidence of fatal HDFN dropped dramatically. However, we are not out of the woods yet!

Call in the Expert!

Dr. Greg Denomme, winner of the 2017 AABB Sally Frank Memorial Award, has studied HDFN and worked in maternal-fetal transfusion for decades, and he is my guest to help us understand why HDFN is still a problem. He will outline clinical and laboratory aspects of HDFN prevention and monitoring, and discuss several cases that illustrate some pitfalls for all involved in these potentially heartbreaking cases.

About My Guest:

Greg Denomme, PhD, FCSMLS(D) (@GregDenomme) is the Senior Director of Immunohematology and Innovation at the BloodCenter of Wisconsin and a Senior Investigator with the Blood Research Institute. He is a clinical and academic trained scientist, and has worked in transfusion medicine his entire career. Dr Denomme obtained his med tech credentials along with an ART and then a doctorate in Microbiology & Immunology, followed by two postdoctoral fellowships (Pathology & Molecular Medicine at McMaster University and platelet immunology with the Canadian Red Cross Society). He received a 5-year Medical Research Council/Canadian Blood Services Scholarship while at the University of Toronto, and his work focused on platelet antigen and blood group genetics and maternal-fetal transfusion medicine. Since moving to the BloodCenter of Wisconsin, Greg has been leading the Immunohematology Reference Lab’s foray into molecular blood group genetics. With his team, he’s developed a donor red cell genotyping program and has expanded patient testing in molecular immunohematology.

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DISCLAIMER: The opinions expressed on this episode are those of my guest and I alone, and do not reflect those of the organizations with which either of us is affiliated. Neither Dr. Denomme nor I have any relevant financial disclosures.

The images below are generously provided by Dr. Denomme.

Denomme Slide 1 - What is HDFN?
Denomme Slide 2 - History of HDFN Treatment
Denomme Slide 3 - HDFN Outcomes
Denomme Slide 4 - Antibodies and antigens involved in HDFN
Denomme Slide 5 - Example of RhD zygosity differences
Denomme Slide 6 - Paternal RhD zygosity testing examples
Denomme Slide 7 - HDFN Management
Denomme Slide 8 - HDFN hemolysis pathophysiology
Denomme Slide 9 - RBC maturation (K is earlier than RhD)
Denomme Slide 10 - HDFN summary

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