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Red cell transfusion and alloimmunization in SCD
effective means of preventing stroke, decreasing postop- erative ACS, and reducing morbidity and mortality in SCD. Given the risks of iron overload, alloimmunization, and DHTR, transfusion should be used judiciously for evidence-based indications or those defined by expert consensus. Despite increased understanding of the patho- physiology of alloimmunization in SCD and improved execution of Rh and K antigen matching, high rates of alloimmunization persist. Future work is necessary to determine whether extended antigen matching or pro- phylactic RH genotype matching can reduce alloimmu- nization in a cost-effective manner. Recruitment of diverse donors and broad implementation of donor geno- typing will increase compatible donors for patients with
SCD. The need to improve safety and ensure access to reliable transfusion therapy for patients with SCD world- wide remains.
Disclosures
No conflicts of interest to disclose.
Contributions
GEL and STC wrote the manuscript.
Acknowledgements
We acknowledge support from the National Institutes of Health/National Heart Lung Blood Institute through grants HL134696 and HL147879-01 (to STC).
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