Strategies for the transfusion of subjects with complex red cell immunisation: the Bank of rare blood donors of the Region of Lombardy.
BACKGROUND
Selecting units of rare blood for transfusion to patients with complex immunisation is one of the most critical processes of a Transfusion Centre. In January 2005 the 'Rare Blood Components Bank - Reference Centre of the Region of Lombardy' w as established with the following goals: 1) identifying regional rare blood donors; 2) creating a regional registry of rare donors; 3) organising a regional bank of liquid and frozen rare blood units; 4) setting up a regional Immunohaematology Reference Laboratory (IRL) to type donors and resolve complex cases.


METHODS
The key elements in establishing the Bank were periodic meetings organised by the directors and representatives of the regional Departments of Transfusion Medicine and Haematology (DTMH) and the institution of three working groups (informatics, regulations, finance).


RESULTS
The regional IRL was set up, the relevant operating procedures were distributed region-wide, software features were defined and later validated upon activation, and the funds assigned were allocated to various cost items. The number and characteristics of the donors to be typed were identified and 14 regional DTMHs started to send samples. Overall, 20,714 donors were typed, for a total of 258,003 typings, and 2,880 rare donors were identified. Of these, 97% were rare donors because of combinations of antigens (2,139 negative for the S antigen and 659 negative for the s antigen) and 3% (n=82) because they were negative for high-frequency antigens. In the first 2 years of activity, the IRL carried out investigations of 140 complex cases referred from other Centres and distributed 2,024 units with rare phenotypes to 142 patients.


CONCLUSIONS
The main goal achieved in the first 24 months from the start of the project was to set up a regional network able to meet the transfusion needs of patients with complex immunisation.
Morelati
Fernanda
F
Centro Trasfusionale e di Immunoematologia, Fondazione Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Istituto di Ricovero e Cura a Carattere Scientifico, DMTE Città di Milano Centro. f.morelati@policlinico.mi.it
Arnaboldi
Piera
P
Barocci
Fiorella
F
Bodini
Umberto
U
Boiani
Elisa
E
Bresciani
Susanna
S
Cambiè
Giuseppe
G
Cazzaniga
Giovanni
G
Cocco
Ernesto
E
Copeta
Alessandro
A
Crotti
Massimo
M
D'Agostino
Francesco
F
D'Agostino
Marco
M
Focchiatti
Valeria
V
Fonti
Elena
E
Galassi
Luigi
L
Gazzola
Giambattista
G
Gelpi
Luigi
L
Greppi
Noemi
N
Inghilleri
Giovanni Battista
GB
Isernia
Paola
P
Manera
Maria Cristina
MC
Marini
Mirella
M
Monti
Rosalia
R
Morales
Rino
R
Moroni
Gianalessandro
G
Morra
Enrica
E
Pau
Maria Paola
MP
Paccapelo
Cinzia
C
Pagliaro
Pasqualepaolo
P
Prati
Daniele
D
Revelli
Nicoletta
N
Rinaldini
Claudia
C
Rossi
Davide
D
Rossi
Fabio
F
Salvaneschi
Laura
L
Sciariada
Luca
L
Sergiacomo
Pierluigi
P
Tiburzi
Alessandra
A
Trotti
Roberta
R
Turdo
Rosalia
R
Velati
Claudio
C
Villa
Maria Antonietta
MA
Vismara
Giuseppina
G
Vitali
Elisabetta
E
Marconi
Maurizio
M