Developing a strategy for red cell antigen typing and matching of blood for chronic transfusion

Davies, Jennifer

Abstract

Red cell allo and autoantibodies have the potential to cause haemolytic transfusion reactions and can also create challenges with subsequent compatibility testing, sourcing compatible blood, delays in the provision of blood and cost implications. A retrospective review of chronically transfused patients revealed considerably higher costs associated with provision of blood for patients with red cell allo/autoantibodies than for non-immunised patients. The risk of development of red cell allo/autoantibodies could be reduced by implementing red cell phenotyping prior to transfusion and matching donor blood for, at least, Rh (CcEe) and K as well as the standard ABO and RhD match. A novel method was validated for performing high throughput extended red cell antigen serological phenotyping on an automated platform which would support a type and match strategy. Red cell genotyping prior to transfusion or following the development of a red cell antibody could also support a strategy for type and match in chronically transfused patients. A platform for this technique was evaluated and the results compared well to the serological assay. A large scale randomised controlled trial to investigate the benefit and cost effectiveness of a type and match strategy has not been attempted in the United Kingdom, therefore a pilot study was performed in which patients were randomly assigned to a standard care or intervention (type and match) group. The pilot study demonstrated the feasibility of a larger scale trial and also informed on the potential to implement a type and match strategy using hospital transfusion service routine blood stocks.

Citation

Davies, J. (2018). Developing a strategy for red cell antigen typing and matching of blood for chronic transfusion. (Thesis). University of the West of England. Retrieved from https://uwe-repository.worktribe.com/output/858549

• Thesis Type: Thesis
• Deposit Date: Sep 24, 2018
• Publicly Available Date: Oct 19, 2018
• Public URL: https://uwe-repository.worktribe.com/output/858549
• Additional Information: Additional Information : Project funded by Royal Devon and Exeter NHS Foundation Trust