TY - JOUR
T1 - Extended red blood cell matching for all transfusion recipients is feasible
AU - van Sambeeck, Joost H. J.
AU - van der Schoot, C. Ellen
AU - van Dijk, Nico M.
AU - Schonewille, Henk
AU - Janssen, Mart P.
N1 - Funding Information: This research was performed as part of the Blood Match project, funded by Sanquin Research (PPOC‐14‐25). Publisher Copyright: © 2021 British Blood Transfusion Society.
PY - 2021
Y1 - 2021
N2 - Objective: To demonstrate the feasibility and effectiveness of extended matching of red blood cells (RBC) in practice. Background: At present, alloimmunisation preventing matching strategies are only applied for specific transfusion recipient groups and include a limited number of RBC antigens. The general assumption is that providing fully matched RBC units to all transfusion recipients is not feasible. In this article we refute this assumption and compute the proportion of alloimmunisation that can be prevented, when all donors and transfusion recipients are typed for A, B, D plus twelve minor blood group antigens (C, c, E, e, K, Fya, Fyb, Jka, Jkb, M, S and s). Methods: We developed a mathematical model that determines the optimal sequence for antigen matching. The model allows for various matching strategies, issuing policies and inventory sizes. Results: For a dynamic inventory composition (accounting for randomness in the phenotypes supplied and requested) and an antigen identical issuing policy 97% and 94% of alloimmunisation events can be prevented, when respectively one and two RBC units per recipient are requested from an inventory of 1000 units. Although this proportion decreases with smaller inventory sizes, even for an inventory of 60 units almost 50% of all alloimmunisation events can be prevented. Conclusion: In case antigen of both donors and recipients are comprehensively typed, extended preventive matching is feasible for all transfusion recipients in practice and will significantly reduce transfusion-induced alloimmunisation and (alloantibody-induced) haemolytic transfusion reactions.
AB - Objective: To demonstrate the feasibility and effectiveness of extended matching of red blood cells (RBC) in practice. Background: At present, alloimmunisation preventing matching strategies are only applied for specific transfusion recipient groups and include a limited number of RBC antigens. The general assumption is that providing fully matched RBC units to all transfusion recipients is not feasible. In this article we refute this assumption and compute the proportion of alloimmunisation that can be prevented, when all donors and transfusion recipients are typed for A, B, D plus twelve minor blood group antigens (C, c, E, e, K, Fya, Fyb, Jka, Jkb, M, S and s). Methods: We developed a mathematical model that determines the optimal sequence for antigen matching. The model allows for various matching strategies, issuing policies and inventory sizes. Results: For a dynamic inventory composition (accounting for randomness in the phenotypes supplied and requested) and an antigen identical issuing policy 97% and 94% of alloimmunisation events can be prevented, when respectively one and two RBC units per recipient are requested from an inventory of 1000 units. Although this proportion decreases with smaller inventory sizes, even for an inventory of 60 units almost 50% of all alloimmunisation events can be prevented. Conclusion: In case antigen of both donors and recipients are comprehensively typed, extended preventive matching is feasible for all transfusion recipients in practice and will significantly reduce transfusion-induced alloimmunisation and (alloantibody-induced) haemolytic transfusion reactions.
KW - alloimmunisation prevention
KW - extended antigen matching
KW - red cell genotyping
UR - http://www.scopus.com/inward/record.url?scp=85120161623&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/tme.12831
DO - https://doi.org/10.1111/tme.12831
M3 - Article
C2 - 34845765
SN - 0958-7578
JO - Transfusion medicine (Oxford, England)
JF - Transfusion medicine (Oxford, England)
ER -