Thread by @TransfusionWM

Extended matched red cells currently very topical. Standard to do this in hbopathy but not (?yet) in haemonc patients. Clear issues with practicalities. Need to consider individual patient versus population needs #F2FNHSBT

Now Fiona Regan on extended matched red cells for hbopathy patients #F2FNHSBT

Hbopathy pts have higher freq of abs; 20-50% in sickle. Currently we only extended match for those with abs (although all get CcDEe and K matched) #F2FNHSBT

Can only Rh and Kell match if the lab know the patient has a hbpoathy! Communication is key... #F2FNHSBT

Rh and K abs constitute 80% abs and may have been reduced by Rh and K matching prospectively #F2FNHSBT

Meeting demand for patients with abs is currently a challenge; providing for all patients would not be feasible as things are #F2FNHSBT

Options for rare units: nationwide search, get rare donors in, frozen blood, or give not fully compatible with IVIG cover - but pts are usually sick so latter is not an easy option #F2FNHSBT

Frozen units take time to be thawed and available - not a quick option for sick patients #F2FNHSBT

Strategic options include increasing donor pool, extended testing on more units, predicting which patients are likely to form abs... #holygrail #F2FNHSBT

Current challenges include increasing need -pts with sickle living longer and more clinical indications for transfusion. Better care and QOL for pts= more blood needed! #F2FNHSBT

>25% red cells go to chronically transfused haematology patients, and >40% of that is in haemonc (from NCA)... haemonc patients tend to make less abs and if no abs after 6 units, chances of subsquent abs are low #F2FNHSBT