Format

Send to

Choose Destination
Transfusion. 2016 Feb;56(2):311-20. doi: 10.1111/trf.13347. Epub 2015 Oct 7.

Incidence of alloantibody formation after ABO-D or extended matched red blood cell transfusions: a randomized trial (MATCH study).

Author information

1
Centre for Clinical Transfusion Research, Sanquin Research.
2
Jon J. Van Rood Centre for Clinical Transfusion Research, Sanquin-Leiden University Medical Centre, Leiden, The Netherlands.
3
LabWest, Haga Teaching Hospital, The Hague, The Netherlands.
4
Department of Haematology, Erasmus Medical Centre, Rotterdam, The Netherlands.
5
Department of Anesthesiology, Albert Schweitzer Hospital, Dordrecht, The Netherlands.
6
Department of Immuno-Hematology and Blood Transfusion, Leiden University Medical Centre, Leiden, The Netherlands.

Abstract

BACKGROUND:

Most incidentally transfused patients receive only ABO-D-compatible transfusions and antibodies are formed in up to 8%. The effect of extended (c, C, E, K, Fy(a) , Jk(a) , and S antigens) matched (EM) and ABO-D-matched red blood cell (RBC) transfusions on the incidence of new clinically relevant RBC antibody formation after a first elective transfusion event in surgical patients was studied.

STUDY DESIGN AND METHODS:

A multicenter randomized trial was performed in nontransfused patients who were scheduled to experience a single elective transfusion event of maximal 4 RBC units. The primary outcome was the incidence of newly formed warm reacting clinically relevant RBC alloantibodies measured in three follow-up (FU) samples taken at 7 to 10 days, 4 to 6 weeks, and 4 to 6 months posttransfusion.

RESULTS:

A total of 853 patients were randomized, and of these, 333 patients were transfused with a total of 1035 RBC units. At least one FU sample was available from 97% of transfused patients. In intention-to-treat analysis, new antibodies were detected in 10 of 155 ABO-D and seven of 178 EM patients, respectively. Per-protocol analysis including 190 patients showed a nonsignificant absolute risk difference (ARD) of 5.3% (95% confidence interval [CI], -1.4% to 12%) in alloimmunization between study arms. In a post hoc analysis of 138 patients who received RBCs but no platelet (PLT) transfusions the ARD increased to significance, 8.0% (95% CI, 0.4-16.0).

CONCLUSION:

Extended matching for selected antigens reduced the alloimmunization risk by 64% in surgical patients. Extended matching seems successful only if the patient did not receive accompanying nonmatched PLT transfusions.

PMID:
26442648
DOI:
10.1111/trf.13347
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center