Impact of Red Blood Cell Antigen Matching on Alloimmunization and Transfusion Complications in Patients with Sickle Cell Disease: A Systematic Review

Fasano, Ross M.; Meyer, Erin; Branscomb, Jane; White, Mia S.; Gibson, Robert W.; Eckman, James R.

doi:10.1016/j.tmrv.2018.07.003

Cited by 53 publications

(36 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In well-resourced countries, patients with SCD often receive transfusions for which RBC antigens are matched between patients and donors [57]. There have been proposals to apply this policy for patients with SCD in SSA, [43,47,51,[53][54].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Red Blood Cell Alloimmunization in Transfused Patients With Sickle Cell Disease in Sub-Saharan Africa; a Systematic Review and Meta-Analysis

Antwi-Boateng

Ngoma

Bates

et al. 2019

Transfusion Medicine Reviews

View full text Add to dashboard Cite

Sickle cell disease (SCD) is the most common monogenic disorder in sub-Saharan Africa (SSA). Blood transfusion to increase the oxygen carrying capacity of blood is vital in the management of many patients with SCD. However, red blood cell (RBC) alloimmunization is a major challenge to transfusions in these patients. Commonly in SSA, pre-transfusion tests only involve ABO D grouping and compatibility without RBC antibody testing. Data on the frequency of RBC alloimmunization in patients with SCD in SSA is limited. We performed a systematic review and meta-analysis on available data on alloimmunization in transfused patients with SCD to determine the published prevalence of RBC alloimmunization in SCD patients in SSA. Six databases were systematically searched to identify relevant studies, without year or language restrictions. In all, 249 articles were identified and 15 met our selection criteria. The overall proportion of alloimmunization was 7.4 (95% CI: 5.1-10.0), per 100 transfused patients. Antibodies against E, D, C and K antigens accounted for almost half of antibody specificities and antibodies to low and high frequency antigens were also common and represented almost 30% (20% to low frequency antigens and 9% to high frequency antigens) of specificities. Heterogeneity between studies was moderate and meta-analysis found region of Africa as the major contributor to the heterogeneity. We also observed inconsistencies across studies in reporting of factors that may influence alloimmunization. This review provides an overview of the extent of the alloimmunization problem in SSA and provides a baseline against which to compare the effect of any interventions to reduce the alloimmunization risk.

show abstract

Section: Accepted Manuscriptmentioning

confidence: 99%

Red Blood Cell Alloimmunization in Transfused Patients With Sickle Cell Disease in Sub-Saharan Africa; a Systematic Review and Meta-Analysis

Antwi-Boateng

Ngoma

Bates

et al. 2019

Transfusion Medicine Reviews

View full text Add to dashboard Cite

show abstract

“…This may be due to unfamiliarity with these recommendations. Alternatively, this may represent a reluctance to adopt ‘cost‐adding’ NHLBI/TIF recommendations due to a lack of high‐quality evidence supporting that universal implementation of RBC antigen matching transfusion protocols significantly impacts patients' risks of haemolytic transfusion reactions (Fasano et al, ). Compared to SCTCs that all indicated that baseline RBC phenotyping for at least Rh (C/c, E/e) and Kell antigens is performed and RBCs are provided, which are matched up front (prior to RBC alloimmunisation) for Rh (C/c, E/e) and K, over 25% of non‐SCTC institutions reported not to perform a RBC phenotype beyond ABO and Rh(D) or provide RBC units that are prophylactically matched for Rh (C/c, E/e) and Kell antigens in accordance with NHLBI recommendations (Yawn et al, ).…”

Section: Discussionmentioning

confidence: 99%

Transfusion service knowledge and immunohaematological practices related to sickle cell disease and thalassemia

Fasano

Branscomb

Lane

et al. 2019

Transfusion Medicine

View full text Add to dashboard Cite

Summary Objectives To assess current knowledge of National Heart, Lung and Blood Institutes (NHLBI) and Thalassemia International Federation (TIF) recommendations, blood banking practices and perceived challenges among transfusion services in the management of patients with haemoglobinopathies. Background Previous reports have demonstrated variations in transfusion practices for sickle cell disease (SCD) and thalassemia patients. Recently, NHLBI/TIF have provided transfusion recommendations for patients with haemoglobinopathies. Methods A cross‐sectional survey was conducted of transfusion services from the state of Georgia previously identified as having SCD/thalassemia populations. The survey assessed transfusion service practices in pre‐transfusion testing and blood product selection; awareness/implementation of NHLBI/TIF transfusion‐based recommendations and perceived challenges in transfusing haemoglobinopathy patients. Results Responses were received from 35 of 49 (71%) institutions. Only institutions indicating transfusing SCD or thalassemia patients (32) were included in analysis. Seventy‐one percent of non‐sickle cell treatment centres (SCTCs) and 20% of non‐thalassemia treatment centres follow NHLBI and TIF recommendations to perform a red blood cell phenotype beyond ABO/Rh(D) and provide Rh and Kell prophylactically matched units for SCD and thalassemia patients, respectively. Forty percent of institutions (33% of non‐SCTCs) employ RBC genotyping to evaluate the red cell phenotype for SCD patients. Over 77% of institutions do not utilise a reliable method to identify SCD patients prior to transfusion, such as a required question/answer field on type/screen or crossmatch orders. Conclusion Many healthcare systems' transfusion practices for haemoglobinopathy patients are discordant with NHLBI/TIF recommendations. Efforts are needed to increase awareness and implementation of current recommendations among all transfusion services seeing these patients.

show abstract

“…The fraction of cells remaining (FCR) was calculated based on historic HbS percentage to achieve sickle hemoglobin percentages <30% or <40% depending on clinical indication. All red blood cell units were leukocyte reduced, sickle negative, and antigen matched based on phenotype or genotype and alloantibody status …”

Section: Methodsmentioning

confidence: 99%

Impact of erythrocytapheresis on natural anticoagulant levels in children with sickle cell disease: A pilot study

Sharma

Woods

Creary

et al. 2018

Pediatric Blood & Cancer

View full text Add to dashboard Cite

Venous thromboembolism (VTE) is being increasingly recognized in children with sickle cell disease (SCD). In a retrospective cohort study, we identified bilateral central venous catheter (CVC) placement as an independent risk factor for VTE. At our institution, the only indication for bilateral CVC placement in children with SCD is erythrocytapheresis. To investigate the impact of erythrocytapheresis on coagulation, we measured levels of natural anticoagulants in 11 patients with SCD on chronic erythrocytapheresis, immediately before and after apheresis. We demonstrated a statistically significant reduction in most parameters. Additional studies are needed to further investigate the exact etiology and clinical impact of this acute decrease.

show abstract

Impact of Red Blood Cell Antigen Matching on Alloimmunization and Transfusion Complications in Patients with Sickle Cell Disease: A Systematic Review

Cited by 53 publications

References 36 publications

Red Blood Cell Alloimmunization in Transfused Patients With Sickle Cell Disease in Sub-Saharan Africa; a Systematic Review and Meta-Analysis

Red Blood Cell Alloimmunization in Transfused Patients With Sickle Cell Disease in Sub-Saharan Africa; a Systematic Review and Meta-Analysis

Transfusion service knowledge and immunohaematological practices related to sickle cell disease and thalassemia

Impact of erythrocytapheresis on natural anticoagulant levels in children with sickle cell disease: A pilot study

Contact Info

Product

Resources

About