A national Transfusion Register of Irregular Antibodies and Cross (X)‐match Problems: TRIX, a 10‐year analysis

Abstract

BACKGROUND: The Transfusion Register of IrregularAntibodies and Cross-match Problems (TRIX) is a unique national database in the Netherlands that was launched in 2007. Transfusion laboratories register the presence of irregular RBC alloantibodies for their patients and can consult the database for information that is relevant for pretransfusion testing, unknown in their own laboratory information system. STUDY DESIGN AND METHODS:Data from the TRIX database 10 years after implementation have been analyzed to demonstrate the added value of TRIX for transfusion practice. TRIX antibody registration, antibody disappearance likelihood, and differences between men and women have been analyzed and evaluated.ABBREVIATIONS: ADL = antibody disappearance likelihood; ADRs = antibody disappearance registrations; LISs = laboratory information systems; TRIX = Transfusion Register of Irregular Antibodies and Cross-match Problems.From the 1 Amphia Hospital, Breda, the

TRIX with treats: the considerable safety benefits of a transfusion medicine registry

“…Transfusion medicine registries have prevented DHTRs caused by antibody evanescence and transfusion medicine record fragmentation. The work of van Gammern and coworkers has demonstrated the technical feasibility of a registry on a national scale . These authors also demonstrated an important step in the future development of registries, namely, engagement with BBIS vendors.…”

“…This investigation along with similar, smaller‐scale studies can help us to determine the number of DHTRs potentially preventable with a transfusion medicine registry. Van Gammeren and coworkers reported 1014 antibody disappearance registrations, defined as an antibody tested for, but undetectable due to evanescence . This number is likely an underestimate given that 50% of sites did not report antibody disappearance registrations.…”

“…The enrollment of all blood banks within a region could overcome the inertia required to initiate a registry. A government‐sponsored or centralized transfusion foundation–based registry may also present a feasible approach to begin with, as was done by van Gammeren and colleagues . Transfusion medicine registries might also be logical outgrowths of existing national health care safety or hemovigilance databases, such as those maintained by the US Centers for Disease Control and Prevention (CDC) or the UK's Serious Hazards of Transfusion (SHOT) database .…”

“…However, despite efforts to apply the most modern, sensitive, and specific assays to blood group antibody detection and identification, several challenges remain. In this issue of TRANSFUSION , van Gammeren and colleagues offer a vital solution for documentation of alloantibodies, namely a national transfusion antibody registry dubbed TRIX (Transfusion Register of Irregular antibodies and Cross(X)‐match problems). TRIX offers a novel and highly valuable model for improving transfusion safety by disseminating a patient's alloimmunization history on a national scale.…”

Optimal red blood cell matching

“…Because antibodies may lose detectability over time, accurate recording and accessibility of patient antibody formation is of the utmost importance [93,95,102]. Besides in-hospital records, a national database is available in the Netherlands (TRIX, Transfusion Register Irregular antibodies and X(cross)-matching), in which hospitals register patients with RBC antibodies and cross-match problems [120]. This system is accessed for the evanesced antibodies in all patients with a transfusion request to prevent re-exposure to the cognate antigen.…”