Blood Bank Guy Essentials Podcast 038: HDFN with Greg Denomme
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Sep 5, 2017 Dr. Greg Denomme, Director of Immunohematology and Transfusion Services at the Blood Center of Wisconsin, dives into the complexities of Hemolytic Disease of the Fetus and Newborn (HDFN). He clarifies the mechanisms behind maternal sensitization and the role of antibodies like anti-D and anti-K. Greg discusses historical advances in management, the significance of MCA Doppler in reducing invasive testing, and fetal genotyping techniques. Practical insights on handling low-risk antibodies and conservative management for anti-D are also highlighted, making HDFN both fascinating and crucial.
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How A Microscope Sparked A Career
- Greg Denomme started in the lab after a high‑school encounter with a microbiologist who explained cultures under a microscope.
- That early curiosity led him through transfusion certification, immunology graduate work, and back to transfusion practice.
Core Mechanism Of HDFN
- HDFN is an IgG-mediated immune response where maternal antibody targets fetal red cell antigens inherited from the father.
- Only IgG crosses the placenta and causes fetal red cell destruction via Fc-mediated phagocytosis.
Major Advances Cut HDFN Mortality
- Management advances (exchange transfusion, antenatal anti-D, ultrasound, MCA Doppler) dramatically reduced HDFN mortality.
- Noninvasive Doppler reduced invasive testing and improved timely interventions like intrauterine transfusion.