Fifty years of RhD immunoglobulin (anti-D) therapy in Australia: celebrating a public health success story

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