To Provide Phenotype-Matched Red Blood Cells or Not – That is the Question!

The availability of molecular immunohematology testing has proven to be a valuable tool in providing blood for patients who require multiple blood transfusions throughout their lifetime.  Testing with traditional serologic techniques is hindered by immunogolobulin coated red cells, the presence of recently transfused red blood cells in the patient sample or panagglutination.  The fact that molecular testing is not affected by these factors makes it effective in resolving complex patient cases and more quickly identifying blood donors whose blood is suitable for transfusion to these patients.

However, does the fact that you know a patient’s phenotype mean they should receive phenotype-matched blood for transfusion?  If the patient has a condition that will require repeated transfusions (sickle cell anemia) or has multiple antibodies, then efforts should be made to match the patient’s phenotype – but anyone who works in a donor center knows how difficult it is to find donors with certain “rare” antigen combinations much less convince them to donate blood on a regular basis. 

DNA analysis allows us to screen more donor units for more antigens more quickly, but it is better suited for screening selected donor populations rather than randomly selected blood units.  How widespread is the demand/use for phenotype-matched blood in your facility?  What practices are in place to meet these requests when an exact match is not available?

Cheri Jennings
SCABB Distinguished Blood Banker

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