Red blood cell specifications for patients with hemoglobinopathies: a systematic review and guideline
Transfus
; 58(6): 1555-1566, June 2018.
Article
em En
| BIGG
| ID: biblio-987782
Biblioteca responsável:
BR1.1
ABSTRACT
BACKGROUND Red blood cell (RBC) transfusions remain essential in the treatment of patients with sickle cell disease (SCD) and ßthalassemia. Alloimmunization, a welldocumented complication of transfusion, increases the risk of delayed hemolytic transfusion reactions, complicates crossmatching and identifying compatible units, and delays provision of transfusions. Guidance is required to optimize the RBC product administered to these patients. STUDY DESIGN AND METHODS An international, multidisciplinary team conducted a systematic review and developed, following the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology, recommendations to assist treating physicians and transfusion specialists in their decision to select RBCs for these patients. RESULTS Eighteen studies (17 clinical studies and one costeffectiveness study) were included in the systematic review. The overall quality of the studies was very low. In total, 3696 patients were included 1680 with ßthalassemia and 2016 with SCD. CONCLUSION The panel recommends that ABO D CcEe Kmatched RBCs are selected for individuals with SCD and ßthalassemia, even in the absence of alloantibodies, to reduce the risk of alloimmunization. In patients with SCD and ßthalassemia who have developed clinically significant alloantibodies, selection of RBCs antigen negative to the alloantibody is recommended, if feasible. In these patients, selection of more extended phenotypematched RBCs will likely reduce the risk of further alloimmunization. However, given the limited availability of extended phenotypematched units, attention should be given to ensure that a delay in transfusion does not adversely affect patient care.
Texto completo:
1
Coleções:
05-specialized
Base de dados:
BIGG
Assunto principal:
Transfusão de Eritrócitos
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Hemoglobinopatias
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Anemia Falciforme
Tipo de estudo:
Guideline
/
Prognostic_studies
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Systematic_reviews
Idioma:
En
Revista:
Transfus
Ano de publicação:
2018
Tipo de documento:
Article