How we incorporate molecular typing of donors and patients into our hospital transfusion service

Shafi, Hedyeh; Abumuhor, Ihab; Klapper, Ellen

doi:10.1111/trf.12582

Cited by 18 publications

(20 citation statements)

References 21 publications

(39 reference statements)

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“…However, the costs of performing genotyping are difficult to estimate because they are highly dependent on the platform that is used for the testing . Substantially lower costs ($47 for reagents, excluding labor) have been reported in high‐throughput environments, and in the future, the costs of these reagents may continue to decline . One group that used a high‐throughput program to genotype both donors and recipients reported a theoretical cost savings of $170,800 per month by using molecular methods to match donors and recipients, rather than paying the blood supplier a per‐antigen fee …”

Section: Discussionmentioning

confidence: 99%

“…114 Substantially lower costs ($47 for reagents, excluding labor) have been reported in high-throughput environments, and in the future, the costs of these reagents may continue to decline. 114,115 One group that used a high-throughput program to genotype both donors and recipients reported a theoretical cost savings of $170,800 per month by using molecular methods to match donors and recipients, rather than paying the blood supplier a per-antigen fee. 115 The ability to inexpensively test blood donors does not ensure the availability of matched RBC units for transfusion.…”

Section: Discussionmentioning

confidence: 99%

“…114,115 One group that used a high-throughput program to genotype both donors and recipients reported a theoretical cost savings of $170,800 per month by using molecular methods to match donors and recipients, rather than paying the blood supplier a per-antigen fee. 115 The ability to inexpensively test blood donors does not ensure the availability of matched RBC units for transfusion. 115,116 Due to the high degree of genetic diversity in the African-American population (particularly in the RH gene), it is possible that large-scale support of a genotypematching program could require increased costs related to donor recruitment and retention.…”

Section: Discussionmentioning

confidence: 99%

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Medical and economic implications of strategies to prevent alloimmunization in sickle cell disease

et al. 2017

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BACKGROUND The pathogenesis of alloimmunization is not well understood, and initiatives that aim to reduce the incidence of alloimmunization are generally expensive and either ineffective or unproven. In this review, we summarize the current medical literature regarding alloimmunization in the sickle cell disease (SCD) population, with a special focus on the financial implications of different approaches to prevent alloimmunization. STUDY DESIGN AND METHODS A review of EMBASE and MEDLINE data from January 2006 through January 2016 was conducted to identify articles relating to complications of SCD. The search was specifically designed to capture articles that evaluated the costs of various strategies to prevent alloimmunization and its sequelae. RESULTS Currently, there is no proven, inexpensive way to prevent alloimmunization among individuals with SCD. Serologic matching programs are not uniformly successful in preventing alloimmunization, particularly to Rh antigens, because of the high frequency of variant Rh alleles in the SCD population. A genotypic matching program could offer some cost savings compared to a serologic matching program, but the efficacy of gene matching for the prevention of alloimmunization is largely unproven, and large-scale implementation could be expensive. CONCLUSIONS Future reductions in the costs associated with genotype matching could make a large-scale program economically feasible. Novel techniques to identify patients at highest risk for alloimmunization could improve the cost effectiveness of antigen matching programs. A clinical trial comparing the efficacy of serologic matching to genotype matching would be informative.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Medical and economic implications of strategies to prevent alloimmunization in sickle cell disease

et al. 2017

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“…Finally, studies have discussed the feasibility of applying molecular typing in the routine of hospital transfusion services 23, 24. Some authors have reported a correlation between the prevention of newly developed alloantibodies in previously immunized patients and reductions in transfusion rates.…”

Section: Discussionmentioning

confidence: 99%

Molecular typing of human platelet antigens in immune thrombocytopenia patients in northern Brazil

Carmo

Klippel

Cordeiro

et al. 2017

Revista Brasileira de Hematologia e Hemoterapia

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BackgroundImmune thrombocytopenia is an immune disease characterized by thrombocytopenia and bleeding due to platelet antibodies against platelet membrane glycoproteins. Human platelet antigens are derived from polymorphisms of these glycoproteins. The aim of this study was to investigate human platelet antigen frequencies in immune thrombocytopenia patients from the state of Amazonas, Brazil and investigate the potential association between specific antigens and risk for immune thrombocytopenia.MethodHuman platelet antigen typing was performed by BeadChip technology to determine allelic variants of 11 systems (HPA-1 to HPA-9, HPA-11 and HPA-15). Thirty-six patients (8 male and 28 female) with a median age of 34 years (range: 9–69 years) were evaluated and compared with data from Amazonas blood donors.ResultsPlatelet counts varied from 3 to 98 × 109/L. The allele frequencies were 0.944 for HPA-1a, 0.056 for HPA-1b, 0.847 for HPA-2a, 0.153 for HPA-2b, 0.555 for HPA-3a, 0.444 for HPA-3b, 0.805 for HPA-5a, 0.222 for HPA-5b, 0.9975 for HPA-9a, 0.025 for HPA-9b, 0.486 for HPA-15a and 0.513 for HPA-15b. Among immune thrombocytopenia individuals, no b allele of the HPA-4, -6, -7, -8 and -11 were found.ConclusionsThe results suggest HPA-1a, HPA-3b and HPA-5b are immune thrombocytopenia-specific autoepitopes.

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“…Notably, a multi-center study 18,19 reported a ‘fill-fraction’ exceeding 90% for common antigen-negative requests. Red cell genotyping involving 3400 to more than 21,000 donors have been also reported 17,20–22 and may be more wide-spread among large blood centers than presently reflected in the literature.…”

Section: Introductionmentioning

confidence: 99%

Integration of red cell genotyping into the blood supply chain: a population-based study

Flegel

Gottschall

Denomme

2015

The Lancet Haematology

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Background When problems with compatibility arise, transfusion services often perform time-consuming serologic testing to locate antigen-negative red cell units for safe transfusion. New technologies enabled red cell genotyping for all clinically relevant blood group antigens. We performed mass-scale genotyping and provided access to a large red cell database to meet the demand for antigen-negative red cell units beyond ABO and Rh. Methods A red cell genotype database was established in 2010. Hospitals were given online access to a web-based antigen query portal in 2013 to find antigen-negative units in their inventories. Findings Genotype data were analyzed for 43,066 blood donors covering a set of 42 clinically relevant red cell antigens. Requests were filled for 5661 of 5672 patient encounters (99.8%) requiring antigen-negative red cell units in a multi-ethnic and multi-racial population. Red cell genotyping met the demand for antigen-negative blood in 5339 of 5672 (95%) patient encounters, while 333 remaining requests were filled using serologic data. In a pilot phase, seven community and rural transfusion services searched their local inventories using an online antigen query portal. Interpretation Red cell genotyping has the potential to transform the way antigen-negative red cell units are provided. An antigen query portal may reduce the need to ship blood or perform serologic screening. The wealth of genotype data, easily accessible online, facilitates the supply of affordable antigen-negative red cell units for patient safety. Physicians may recognize these new efficiencies for patient transfusion support. Funding BloodCenter of Wisconsin Diagnostic Laboratories Strategic Initiative and the NIH Clinical Center Intramural Research Program.

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How we incorporate molecular typing of donors and patients into our hospital transfusion service

Cited by 18 publications

References 21 publications

Medical and economic implications of strategies to prevent alloimmunization in sickle cell disease

Medical and economic implications of strategies to prevent alloimmunization in sickle cell disease

Molecular typing of human platelet antigens in immune thrombocytopenia patients in northern Brazil

Integration of red cell genotyping into the blood supply chain: a population-based study

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