How best to avoid the problem of alloimmunization in SCD
| Donors | 1. Promotion of donation among donors of African ancestry |
| 2. Extended pheno/genotype of donors | |
| Blood units | 3. Tag blood units from donors of African ancestry to direct them specifically to SCD centers |
| SCD patients | 4. Extended pheno/genotype at first opportunity |
| 5. Sensitive pretransfusion screening test including research of antibodies against low-prevalence antigens | |
| 6. Repeated screening tests after transfusion to detect primary immunization | |
| 7. Keep a well-maintained transfusion file available to all hospitals | |
| Technical developments | 8. Development of low-cost genotyping methods |
| Transfusion indications | 9. Judicious transfusion indication in high-risk patients |
| Research | 10. Parameters characterizing low and high responders before first transfusion |
| 11. Revisiting parameters of clinical significance of erythrocyte antibodies | |
| 12. Determination of clinically significant RH variants to consider | |
| 13. Mechanism of alloimmunization and possible intervention with immunosuppressive drugs | |
| 14. Impact of RBC product characteristics besides Ag matching on alloimmunization (age, microparticles, other components) | |
| 15. Optimal RBC products to decrease the need for transfusion and exposure (improved oxygen delivery and life span, role of G6PD deficiency and sickle trait in donors) | |
| 16. Development of new treatments for SCD (gene therapy, new molecules) |
| Donors | 1. Promotion of donation among donors of African ancestry |
| 2. Extended pheno/genotype of donors | |
| Blood units | 3. Tag blood units from donors of African ancestry to direct them specifically to SCD centers |
| SCD patients | 4. Extended pheno/genotype at first opportunity |
| 5. Sensitive pretransfusion screening test including research of antibodies against low-prevalence antigens | |
| 6. Repeated screening tests after transfusion to detect primary immunization | |
| 7. Keep a well-maintained transfusion file available to all hospitals | |
| Technical developments | 8. Development of low-cost genotyping methods |
| Transfusion indications | 9. Judicious transfusion indication in high-risk patients |
| Research | 10. Parameters characterizing low and high responders before first transfusion |
| 11. Revisiting parameters of clinical significance of erythrocyte antibodies | |
| 12. Determination of clinically significant RH variants to consider | |
| 13. Mechanism of alloimmunization and possible intervention with immunosuppressive drugs | |
| 14. Impact of RBC product characteristics besides Ag matching on alloimmunization (age, microparticles, other components) | |
| 15. Optimal RBC products to decrease the need for transfusion and exposure (improved oxygen delivery and life span, role of G6PD deficiency and sickle trait in donors) | |
| 16. Development of new treatments for SCD (gene therapy, new molecules) |