In 2017, Australia celebrated the 50th anniversary of the anti-D program, which uses the plasma of special donors to protect the babies of millions of Australian women
At the 11th Congress of the International Society of Blood Transfusion held in Sydney in 1966, researchers from Liverpool1 and New York2 announced the first successful trials of Rhesus (Rh) D immunoglobulin (Ig) — or anti-D — derived from human plasma to prevent the effects of RhD blood group incompatibility between an RhD-negative mother and an RhD-positive baby. Antibodies generated from alloimmunisation may cross the placenta in subsequent pregnancies and cause haemolytic disease of the fetus and newborn (HDFN). The haemolysis of the baby’s red cells may result in anaemia and jaundice, and in severe cases brain damage or death of the baby. The researchers in 1966 had found that the Ig fraction from the plasma of women who had had this reaction, when injected into at-risk mothers immediately after the first birth, acted as a passive vaccine by preventing this immunisation reaction and protecting subsequent births. Attending the conference, Dr Gustav Nossal of the Walter and Elisa Hall Institute said: “We do not often have the privilege to be present at the beginning of one of the revolutions of medicine”.3
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- 1. Finn R, Clarke CA. The prevention of Rhesus haemolytic disease. Bibl Haematol 1968; 29: 225-230.
- 2. Gorman JG, Freda VJ, Pollack W. Prevention of Rh isoimmunization with anti-Rh gamma G globulin clinical trial on mothers. Bibl Haematol 1968; 29: 273.
- 3. Nossal G. Prevention of Rh haemolytic disease: a report of a round-table discussion on August 26, 1966, at the XIth Congress of the International Society of Blood Transfusion in Sydney Australia. Bulletin of the Post-Graduate Committee in Medicine, University of Sydney 1967; 23: 47.
- 4. Cortiula M. Banking on blood: a history of the Australian Red Cross New South Wales Transfusion Service. Walcha: Ohio Publications, 2001.
- 5. Consultative Council on Obstetric and Paediatric Mortality and Morbidity. Annual reports 1965–2016. https://www2.health.vic.gov.au/hospitals-and-health-services/quality-safety-service/consultative-councils/council-obstetric-paediatric-mortality/mothers-babies-children-report (viewed Aug 2018).
- 6. Pearn JH. Erythroblastosis fetalis – the discovery and partial elimination of rhesus incompatibility – the origins of exchange transfusion in Australia. Pathology 1994; 26: 176-182.
- 7. Davey MG. Rh Project in Australia since 1967. Tenth Anniversary 1967-1977 Rh Project. NSW Red Cross Blood Transfusion Service, 1977.
- 8. Davey MG. Prevention of rhesus immunization in Australia: the first seven years. Med J Aust 1975; 2: 263-267.
- 9. National Blood Authority. Guidelines on the prophylactic use of Rh D immunoglobulin (anti-D) in obstetrics. Canberra: NBA, 2003. https://www.blood.gov.au/system/files/documents/glines-anti-d.pdf (viewed Aug 2017).
- 10. Pal M, Williams B. Prevalence of maternal red cell alloimmunisation: a population study from Queensland, Australia. Pathology 2015; 47: 151-155.
Australian governments fund the Australian Red Cross Blood Service to provide blood, blood products and services to the Australian community. Dr Sophie Treleaven of the Consultative Council on Obstetric and Paediatric Mortality and Morbidity (Victoria) provided extensive data. Ms Robyn Barlow and Dr Anne Fletcher kindly provided historical advice and materials.
No relevant disclosures.