Is the c c e e K‑negative Rh‑positive blood type unusual?

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Is the ccEE K- Rh+ Blood Type Unusual?

No, the ccEE K- Rh+ blood type is not particularly unusual, though it is less common than some other Rh phenotypes. This phenotype represents a specific combination of Rh antigens (c positive, C negative, E positive, e negative) with K-negative status, which occurs with variable frequency depending on ethnic background.

Understanding the Phenotype Frequency

Rh Antigen Distribution

  • The "e" antigen is the most common Rh antigen, found in 96.80-98.3% of populations, while your phenotype is "e negative" which makes it less common 1, 2
  • The "E" antigen (which you have) occurs in approximately 17.9-32.2% of individuals depending on ethnic background 1, 2
  • The "c" antigen (which you have) is present in 34.4-52.82% of donors 1, 2
  • The "C" antigen (which you lack) is found in 84.76-95.5% of individuals, making C-negative status relatively uncommon 1, 2

K Antigen Status

  • K-negative status is actually the norm, as only 5.56% of blood donors are K-positive 1
  • Being K-negative is therefore the common phenotype and does not contribute to rarity 1

Clinical Significance

Transfusion Considerations

  • If you require blood transfusions, matching for C, c, E, e, and K antigens is strongly recommended to prevent alloimmunization 3
  • The American Society of Hematology recommends prophylactic red cell antigen matching for Rh (C, E or C/c, E/e) and K antigens for patients receiving chronic transfusions, as antibodies to these antigens are among the most common and clinically significant 3
  • Your ccEE phenotype means you should receive c-positive, C-negative, E-positive, e-negative blood to avoid developing antibodies 3

Risk of Alloimmunization

  • Antibodies to C, E, and K antigens are historically the most common specificities that complicate transfusion 3
  • Matching for Rh and K antigens reduces the incidence of new alloantibodies from 3.1 per 100 units (with ABO/RhD matching only) to 0.9 per 100 units 3
  • The presence of anti-E antibodies can cause acute hemolytic transfusion reactions, delayed hemolytic reactions, and hemolytic disease of the newborn 4

Common Pitfalls

  • Do not assume standard ABO/RhD matching is sufficient if you need chronic transfusions - extended phenotype matching significantly reduces complications 3
  • If you develop antibodies, finding compatible blood becomes progressively more difficult with each additional antibody formed 3
  • Pregnancy considerations: if you are female and become pregnant, your phenotype could be relevant for hemolytic disease of the fetus and newborn if there is Rh incompatibility 3

Bottom Line

Your ccEE K- Rh+ phenotype is uncommon but not rare. The combination of being e-negative and C-negative occurs in a minority of the population, but K-negative status is typical. The main clinical importance is ensuring proper antigen matching if you ever require blood transfusions to prevent alloimmunization and its associated complications 3, 5.

References

Research

Phenotype frequencies of blood group systems (Rh, Kell, Kidd, Duffy, MNS, P, Lewis, and Lutheran) in north Indian blood donors.

Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis, 2010

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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