American Red Cross Biomedical Services Philadelphia, Pennsylvania, United States
Background/Case Studies: Integration of molecular testing into blood centers has been critical to identifying rare blood donors to meet the needs of alloimmunized patients. The ARDP has more than 100,000 rare blood donors identified by serologic and/or molecular methods. The program includes 89 Immunohematology Reference Laboratories (IRLs), 76 affiliated with blood collecting facilities, of which three are outside the US (OUS). Molecular testing is not performed on every donor or donation. As a result, blood centers develop strategies to efficiently utilize the technology. The ARDP advisory committee, including ARDP staff and representatives from member facilities, developed a survey to assess how members use molecular methods to identify rare blood donors.
Study
Design/Methods: A survey was developed using REDCap software. The survey was emailed to 207 staff at 89 member facilities requesting one response per blood-collecting facility-based IRL. Responses were analyzed using Microsoft Excel and some responses were updated after clarification via email.
Results/Findings: Thirty of the 76 blood collecting facilities from 17 organizations responded, including 14 responses from American Red Cross facilities. Two respondents were from OUS. All respondents reported using molecular testing to screen blood donors. Twelve organizations performed testing in-house and 5 reported outsourcing the testing.When selecting donors for testing, 81% reported using donor self-declared race/ethnicity and the majority used ABO types as a selection criteria; 23% select group O, A or B, 20% group O and 13% Group O or A. Regarding donation history, 46% reported selecting donors who donated two or more times, 27% selected first-time donors and 20% do not use donation history. Additionally, 53% of respondents select donors based on C-E-, C-E-K- or C-E-K- serologic phenotypes with HgbS- status. Most(82%) reported using genotyping panels from Werfen or Grifols while others used panels from inno-train Diagnostik or Agena Bioscience. Most facilities (65%) reported that genotype-predicted phenotypes are automatically uploaded into the Blood Establishment Computer System (BECS), while 29% enter all data manually and 6% enter a subset of data manually. None of the facilities reported labeling blood products with phenotype information derived solely from molecular testing. Conclusions: The survey responses provide details regarding approaches used by 30 ARDP member facilities representing 17 blood collecting organizations. Most facilities reported performing molecular testing in-house and using donor race/ethnicity for testing eligibility. More than half of the facilities automatically upload molecular results to their BECS. Approaches to select donors for molecular testing varied regarding use of ABO type, prior serologic type and donation history. No facility reported including genotype-predicted phenotype results on their blood product labels.
