Precision Transfusion Management: Rh Phenotype Compatibility and Antibody Surveillance in Southern China

ObjectiveTo analyze Rh antigen (C, c, D, E, e) distribution and alloimmunization patterns in Hengyang, China, and establish precision transfusion strategies. MethodsRh phenotyping and antibody screening were performed on 3,635 hospitalized patients and 5,326 donors using serological cards. A transfusion management system tracked historical antibodies and flagged discrepancies. ResultsAntigen frequencies in patients were D (99.56%) > e (94.69%) > C (91.64%) > c (48.06%) > E (38.79%). Dominant Rh(D)-positive phenotypes included CCDee (51.31%) and CcDEe (30.01%). After implementing Rh-matched transfusions (March-October 2023), antibody screening positivity decreased from 1.14% (2022) to 0.97% (p < 0.05). Rh system antibodies accounted for 46.01% (127/276) of positives in 2023, down from 55.21% in 2022 (p < 0.05), and were the leading cause of crossmatch incompatibility. ConclusionRh antigen-matched transfusions significantly reduce alloimmunization risks. Continuous antibody tracking via transfusion management systems enhances transfusion safety.