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Blood Transfus. 2007 Nov;5(4):217-26. doi: 10.2450/2007.0016-07.

Strategies for the transfusion of subjects with complex red cell immunisation: the Bank of rare blood donors of the Region of Lombardy.

Blood transfusion = Trasfusione del sangue

Fernanda Morelati, Piera Arnaboldi, Fiorella Barocci, Umberto Bodini, Elisa Boiani, Susanna Bresciani, Giuseppe Cambiè, Giovanni Cazzaniga, Ernesto Cocco, Alessandro Copeta, Massimo Crotti, Francesco D'Agostino, Marco D'Agostino, Valeria Focchiatti, Elena Fonti, Luigi Galassi, Giambattista Gazzola, Luigi Gelpi, Noemi Greppi, Giovanni Battista Inghilleri, Paola Isernia, Maria Cristina Manera, Mirella Marini, Rosalia Monti, Rino Morales, Gianalessandro Moroni, Enrica Morra, Maria Paola Pau, Cinzia Paccapelo, Pasqualepaolo Pagliaro, Daniele Prati, Nicoletta Revelli, Claudia Rinaldini, Davide Rossi, Fabio Rossi, Laura Salvaneschi, Luca Sciariada, Pierluigi Sergiacomo, Alessandra Tiburzi, Roberta Trotti, Rosalia Turdo, Claudio Velati, Maria Antonietta Villa, Giuseppina Vismara, Elisabetta Vitali, Maurizio Marconi

Affiliations

  1. Centro Trasfusionale e di Immunoematologia, Fondazione Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Istituto di Ricovero e Cura a Carattere Scientifico, DMTE Città di Milano Centro. [email protected]

PMID: 19204778 PMCID: PMC2581908 DOI: 10.2450/2007.0016-07

Abstract

INTRODUCTION: Selecting units of rare blood for transfusion to patients with complex immunisation is one of the most critical processes of a Transfusion Centre. In January 2005 the 'Rare Blood Components Bank - Reference Centre of the Region of Lombardy' w as established with the following goals: 1) identifying regional rare blood donors; 2) creating a regional registry of rare donors; 3) organising a regional bank of liquid and frozen rare blood units; 4) setting up a regional Immunohaematology Reference Laboratory (IRL) to type donors and resolve complex cases.

METHODS: The key elements in establishing the Bank were periodic meetings organised by the directors and representatives of the regional Departments of Transfusion Medicine and Haematology (DTMH) and the institution of three working groups (informatics, regulations, finance).

RESULTS: The regional IRL was set up, the relevant operating procedures were distributed region-wide, software features were defined and later validated upon activation, and the funds assigned were allocated to various cost items. The number and characteristics of the donors to be typed were identified and 14 regional DTMHs started to send samples. Overall, 20,714 donors were typed, for a total of 258,003 typings, and 2,880 rare donors were identified. Of these, 97% were rare donors because of combinations of antigens (2,139 negative for the S antigen and 659 negative for the s antigen) and 3% (n=82) because they were negative for high-frequency antigens. In the first 2 years of activity, the IRL carried out investigations of 140 complex cases referred from other Centres and distributed 2,024 units with rare phenotypes to 142 patients.

CONCLUSIONS: The main goal achieved in the first 24 months from the start of the project was to set up a regional network able to meet the transfusion needs of patients with complex immunisation.

Keywords: banks and registries of rare donors; complex red cell immunisation; transfusion support

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