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

James Thyer, Janet Wong, Amanda Thomson, Barbara Bell, Catherine Hyland and Daniel Challis
Med J Aust 2018; 209 (8): . || doi: 10.5694/mja17.01144
Published online: 15 October 2018

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


  • 1 Australian Red Cross Blood Service, Melbourne, VIC
  • 2 Australian Red Cross Blood Service, Sydney, NSW
  • 3 Australian Red Cross Blood Service, Brisbane, QLD
  • 4 Pregnancy and Newborn Services Network, Sydney Children's Hospital, Randwick, Sydney, NSW



Acknowledgements: 

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.

Competing interests:

No relevant disclosures.

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  • 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.
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  • 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.

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