The RH locus encodes RhD and RhCE proteins. (A) RHD and RHCE have 10 exons (boxes), reside on chromosome 1 in reverse orientation, and are separated by ∼30 kilobases (kb). More than 600 RHD and 150 RHCE alleles have been reported. (B) RHD encodes the principal D antigen, and RHCE encodes both C/c and E/e antigens on a single protein in 4 combinations (ce, cE, Ce, or CE). The E and e antigens differ by 1 amino acid, a proline or alanine at position 226, denoted by the dark blue circle. There are 4 amino acid differences between C and c at positions 16, 60, 68, and 103, which are denoted by light blue circles. High-prevalence antigens are those that are expressed by >99% of populations, and many variant RH alleles are associated with a loss of expression of high-prevalence antigens. New or variant antigens arise from single-nucleotide variants lines or gene rearrangements such as structural variations. Figure created with BioRender.com.