A simple, practical model for reducing alloimmunization in patients with sickle cell disease

✍ Scribed by Dr. Steven D. Sosler; Bernard J. Jilly; Catherine Saporito; Mabel Koshy

• Publisher: John Wiley and Sons
• Year: 1993
• Tongue: English
• Weight: 350 KB
• Volume: 43
• Category: Article
• ISSN: 0361-8609
• DOI: 10.1002/ajh.2830430206

✦ Synopsis

Patients with sickle cell disease (SCD) form immune alloantibodies more frequently than other transfused populations because red cells (RBCs) from white donors (with a higher incidence of certain Rh, Duffy, Kell, and Kidd blood group antigens) are transfused to black patients often lacking these antigens. We propose a model to reduce alloimmunization in patients with SCD by providing them with blood from only black random donors.

Rationale is shown by examining calculations based on the phenotype E-, C-, Fy(a-), K-, and Jk(b-). There is a 7% probability that this phenotype belongs to a white donor, while there is a 93% probability that this phenotype belongs to a black donor. The probability of selecting blood from a black donor identical with the above phenotype for black recipients from an all black population and from a typical urban blood inventory population (goo/, white, 10% black) is 114 and 1/33, respectively. Therefore, an 8-fold greater chance of selecting antigen non-identical blood occurs if blood is obtained from a typical urban donor population as compared to a black population. Based on these calculations, alloimmunization can be reduced prospectively in patients with SCD by meeting their transfusion requirements with blood selected from random black blood donors.