The Rhesus Immunization Surveillance (RIR)
Rhesus Immunisierungsregister
DRK-Blutspendedienst Baden-Württemberg
Institut Ulm
Rhesus-Labor
Helmholtzstrasse 10

D-89081 Ulm

Germany
Report and Mailing Form
Please inquire, if in doubt about the inclusion and exclusion criteria:
Willy A. Flegel, PD Dr. med.: +49-731-150-600 or -601, waf@ucsd.edu
Lab: +49-731-150-610, FAX +49-731-150-602
RIR Online-Information:
http://www.uni-ulm.de/~wflegel/RH/RIR/
Required blood volumes: 10 ml whole blood (serum) and 10 ml EDTA-blood
in case of stored/frozen blood samples: please inquire about blood volume

Proband:
(Family and First name, or Initials, and Birthdate)
Residence:
(City, County or State)
Sex: O female O male
Time of immunization: O known O unknown
before 1 Jan 1997:
 O proven O possible O impossible
after 1 Jan 1997:
 O proven O possible O impossible
Exact history of transfusions and pregnancies:

 
Criteria for inclusion (all items must apply):
 O yes   O no  Proband is Rhesus D-positive or it was not possible to exclude an antigen D or RHD-specific nucleotide sequences.
 O yes   O no  Proband carries an anti-D antibody or it was not possible to exclude an anti-D.
 O yes   O no  Proband is properly identified by initials, birthday and residence (country). The exact and complete history for transfusions and pregnancies is provided.
Criteria for exclusion (no item may apply):
 O yes   O no  Proband is Rhesus negative (D neg.).
 O yes   O no  Proband with proven negative transfusion and pregnancy history.
The sender accepts the conditions of The Rhesus Immunization Surveillance (RIR) of the German Society for Transfusion Medicine and Immunohematology (DGTI).
 
 
 

Date, Sender (Stamp, please provide name and telephone number of the person in charge)


16 October 2000