title: A simple, practical model for reducing alloimmunization in patients with sickle cell disease.
abstract: Patients with sickle cell disease (SCD) form immune alloantibodies more frequently than other transfused populations because red cells (RBCs) from white donors (with a higher incidence of certain Rh, Duffy, Kell, and Kidd blood group antigens) are transfused to black patients often lacking these antigens. We propose a model to reduce alloimmunization in patients with SCD by providing them with blood from only black random donors. Rationale is shown by examining calculations based on the phenotype E-, C-, Fy(a-), K-, and Jk(b-). There is a 7% probability that this phenotype belongs to a white donor, while there is a 93% probability that this phenotype belongs to a black donor. The probability of selecting blood from a black donor identical with the above phenotype for black recipients from an all black population and from a typical urban blood inventory population (90% white, 10% black) is 1/4 and 1/33, respectively. Therefore, an 8-fold greater chance of selecting antigen non-identical blood occurs if blood is obtained from a typical urban donor population as compared to a black population. Based on these calculations, alloimmunization can be reduced prospectively in patients with SCD by meeting their transfusion requirements with blood selected from random black blood donors.
authors.affiliation: University of Illinois College of Medicine, Department of Pathology, Chicago 60612.
authors.forename: S D
authors.initials: SD
authors.lastname: Sosler
authors.forename: B J
authors.initials: BJ
authors.lastname: Jilly
authors.forename: C
authors.initials: C
authors.lastname: Saporito
authors.forename: M
authors.initials: M
authors.lastname: Koshy
mesh_terms: D000917:Antibody Formation; D044383:Black People; D001782:Blood Donors; D001803:Blood Transfusion; D006801:Humans; D007518:Isoantibodies / Q000276:immunology*; D007519:Isoantigens / Q000032:analysis; D010641:Phenotype; D011897:Random Allocation; D012805:Sickle Cell Trait / Q000276:immunology* / Q000628:therapy*; D014505:Urban Population; D044465:White People
chemical_list: D007518:Isoantibodies; D007519:Isoantigens