title: Phenotype matching of donor red blood cell units for nonalloimmunized sickle cell disease patients: a survey of 1182 North American laboratories.
abstract: BACKGROUND
  The transfusion of donor red blood cell units (RBCs) that lack certain red cell antigens (such as C, E, and K) when the corresponding antigens are absent from the recipient's red cells has been shown to reduce the risk of red cell alloimmunization in sickle cell disease patients. However, data are limited regarding the extent to which transfusion services routinely perform red cell antigen phenotype testing of nonalloimmunized sickle cell disease patients, and then use that information to select donor RBCs lacking 1 or more of the red cell antigens that the patient's red cells do not express.
  
  
  OBJECTIVE
  To determine the extent to which transfusion services routinely perform red cell antigen phenotype testing of nonalloimmunized sickle cell disease patients, and then use that information to select donor RBCs lacking 1 or more of the red cell antigens that the patient's red cells do not express.
  
  
  METHODS
  An educational subsection of a College of American Pathologists Proficiency Testing Survey (J-C 2003) assessed transfusion service practices regarding performance of red cell antigen phenotype testing of nonalloimmunized sickle cell disease patients and how transfusion services use this information for the selection of donor RBCs. The data analysis of the survey included 1182 North American laboratories.
  
  
  RESULTS
  Data from 1182 laboratories were included in the survey analysis, of which the majority (n = 743) reported that they did not routinely perform phenotype testing of sickle cell disease patients for antigens other than ABO and D. The other 439 laboratories reported that they did routinely perform phenotype testing of sickle cell disease patients for antigens in addition to ABO and D. The majority of these 439 laboratories (three fourths; n = 330) reported that they used these patient data for prophylactic matching with donor RBCs when sickle cell disease patients required transfusion. When phenotype-matched donor RBCs were used, the antigens most commonly matched (85% of the time) were C, E, and K.
  
  
  CONCLUSIONS
  The majority of North American hospital transfusion service laboratories do not determine the red cell antigen phenotype of nonalloimmunized sickle cell disease patients beyond ABO and D. Those laboratories that do determine the red cell phenotype of nonalloimmunized sickle cell disease patients beyond ABO and D most commonly match for C, E, and K antigens when phenotype-matched donor RBCs are used.
authors.affiliation: Department of Pathology, Los Angeles County-University of Southern California Medical Center, Los Angeles 90033, USA.
authors.forename: Melanie
authors.initials: M
authors.lastname: Osby
authors.forename: Ira A
authors.initials: IA
authors.lastname: Shulman
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology; D000755:Anemia, Sickle Cell / Q000097:blood; D001771:Blood Banks / Q000592:standards*; D001782:Blood Donors / Q000145:classification*; D001789:Blood Group Antigens / Q000032:analysis; D001788:Blood Grouping and Crossmatching / Q000379:methods; D001803:Blood Transfusion / Q000379:methods*; D003625:Data Collection / Q000379:methods; D004912:Erythrocytes / Q000737:chemistry / Q000378:metabolism; D006801:Humans; D009656:North America; D010641:Phenotype; D012204:Rh-Hr Blood-Group System / Q000276:immunology
chemical_list: D000017:ABO Blood-Group System; D001789:Blood Group Antigens; D012204:Rh-Hr Blood-Group System