Antigen-matched donor blood in the transfusion management of patients with sickle cell disease.
BACKGROUND
Alloimmunization to red cell antigens is a significant risk in chronically transfused patients with sickle cell disease. Antigen matching, by decreasing the likelihood of alloantibody development, may significantly facilitate long-term management while decreasing morbidity.


METHODS
The transfusion records of 86 patients who underwent chronic transfusion for sickle cell disease at a tertiary-care medical center were reviewed retrospectively to determine the efficacy of an antigen-matching program in the prevention of alloimmunization to clinically significant red cell antigens. Recipients were phenotyped and given units matched for the K, C, E, S, and Fya or Fyb antigens.


RESULTS
None (0%) of the 40 patients who received antigen-matched transfusions showed any evidence of alloimmunization, while 16 (34.8%) of the 46 patients who received both antigen-matched and non-antigen-matched transfusions developed clinically significant alloantibodies. The cost was 1.8 to 1.5 times that for a standard transfusion protocol.


CONCLUSIONS
On the basis of this experience, it is recommended that transfusion centers engaged in the management of chronically transfused sickle cell anemia patients consider providing antigen-matched units for such patients. This is recommended not only because it prevents alloimmunization but also because such a program provides additional clinical benefits to the patient that may outweigh the higher costs of the process.
Tahhan
H R
HR
Department of Pathology and Laboratory Medicine, Pitt County Memorial Hospital (PCMH)-East Carolina University School of Medicine (ECU-SOM), Greenville, North Carolina.
Holbrook
C T
CT
Braddy
L R
LR
Brewer
L D
LD
Christie
J D
JD
D000755:Anemia, Sickle Cell / Q000628:therapy*; D001782:Blood Donors; D001788:Blood Grouping and Crossmatching; D001803:Blood Transfusion; D005260:Female; D006801:Humans; D007518:Isoantibodies / Q000097:blood; D008297:Male; D012189:Retrospective Studies
D007518:Isoantibodies