weak D type 4.0



Key changes from standard allele

602C>G (T201R)
667T>G (F223V)

ISBT allele designation


Nucleotide changes relative to "standard RHD"

c.[602 C>G;667 T>G;819 G>A]

Amino acid changes relative to standard protein

T201R, F223V, A273A

ISBT group

partial RHD

Phenotype characterization and grouping

weak D type; weakened D expression; Partial D

Haplotype (typical)


Allele cluster

weak D type 4 cluster


First full publication: 1999 Wagner FF et. al. Blood. 1999 Jan 1;93(1):385-93.

Other relevant descriptions:
alterations in non-coding region: 336-56 delATGA, 802-16C>T, 1227+55A>G KR260900 (submitted 2015-04-20, released 2016-07-04)
KR260901 (submitted 2015-04-20, released 2017-03-07)


Rhesus Index 0.36 Wagner FF et. al. Blood. 2000 Apr 15;95(8):2699-708.
Kormoczi GF et. al. Transfusion. 2005 Oct;45(10):1574-80.
allo-anti-D observed Rhesus immunization registry


Brazil (general): 81 of 369 samples with atypical D expression Arnoni CP et. al. Transfusion. 2014 Apr;54(4):962-9. doi: 10.1111/trf.12557. Epub 2014 Feb 28.
South-Western Germany: Wagner FF et. al. Blood. 1999 Jan 1;93(1):385-93. Frequency 1:14.925
Tyrol: 4 of 130 weak D samples Muller TH et. al. Transfusion. 2001 Jan;41(1):45-52.
African American: SWiTCH trial Chou ST et. al. Blood Adv. 2017 Aug 3;1(18):1414-1422. doi: 10.1182/bloodadvances.2017007898. Frequency 1:0,028
African ancestry (general): possibly frequent among Africans Hemker MB et. al. Blood. 1999 Dec 15;94(12):4337-42.
French of African ancestry: 2 of 280 D pos donors, in addition 4 alleles in heterozygous state Kappler-Gratias S et. al. Blood Transfus. 2014 Jan;12 Suppl 1:s264-72. doi: 10.2450/2013.0270-12. Epub 2013
Northern Germany: 1 of 159 weak D samples Muller TH et. al. Transfusion. 2001 Jan;41(1):45-52.
Tunisia (general): 1 of 448 seemingly D negative samples Moussa H et. al. Transfus Med. 2012 Mar 16. doi: 10.1111/j.1365-3148.2012.01142.x.

Related Alleles

DIII type 5 [RHD(L62F,A137V,N152T,T201R,F223V)]
DIII type 6 [RHD(A137V,N152T,T201R,F223V,A273A)]
DIII type 7 [RHD-RHCE(2)-RHD(A137V,N152T,T201R,F223V)]
DIIIa150C [RHD(150T>C,L62F,A137V,N152T,T201R,F223V,819G>A)]
weak D type 4.4 [RHD(K198N,T201R,F223V)]
RHD(T201R,F223V,G307R) [RHD(T201R,F223V,G307R)]
weak D type 4.5 [RHD(T201R,F223V,G355S)]
RHD(T201R,F223V,K264N,A273A) [RHD(T201R,F223V,K264N,A273A)]
RHD-RHCE(3)--weak D type 4.0 [RHD-RHCE(3)-RHD(T201R,F223V,819G>A)]
weak D type 4.1 [RHD(W16C,T201R,F223V)]
weak D type 4.3 [RHD(T201R,F223V,P291R)[819G>A]]

Additional comments

This allele was initially described as weak D type 4 and has a much lower alloimmunization potential than the "true" DAR-alleles carrying I342T. Although the original DAR publication investigated a sample with a considerably different phenotype and reported an incorrect sequence, the ISBT chose to use the DAR naming for the whole RHD(T201R, F223V) related branch.

Last update: 2018-04-23 (yyyy-MM-dd)