Question 53: Were any red blood cell (RBC) transfusions administered?
Red blood cell (RBC) transfusions are often given as supportive care for recipients with thalassemia.
Indicate if any red blood cell transfusions were administered between diagnosis and the start of the preparative regimen / infusion. If the recipient did not receive any RBC transfusions or no information is available to determine if the recipient received transfusion, report No and continue with Direct bilirubin.
Questions 54 – 55: Number of RBC transfusion events with the last 12 months
Transfusions may be referred to as “simple” or “exchange” transfusions. A simple transfusion refers to a direct infusion of a blood product. An exchange transfusion refers to the slow removal and replacement of the recipient’s blood with that of a healthy donor’s blood. A transfusion event consists of one or more RBC unit(s) given in a day.
Indicate the total number of RBC transfusion events the recipient received within 12 months prior to the start of the preparative regimen / infusion and specify the date (YYYY-MM-DD) of the last transfusion administered. If the exact date is not known report an estimated date and check the Date estimated box. Refer to General Instructions, General Guidelines for Completing Forms for information about reporting estimated dates.
Example A: The progress notes state a recipient was transfused with one RBC unit each month, for six months. The number of transfusions increased, and the recipient receives two RBC units on the same day, each month, for the following six months prior to the start of the preparative regimen. The total number of RBC transfusion events within the last 12 months would be reported as “12.”
Question 56: Were the RBC units used for transfusion of an extended phenotype match (D, C, c, E, e, K)? (includes partial extended phenotype matches)
Extended phenotype testing may be performed on RBC units prior to transfusion to ensure donor and recipient matches are confirmed beyond the standard ABO compatibility matching to decrease the risk of alloimmunization. This information is typically found within the blood bank section of the medical record.
Report Yes if the RBC unit(s) used for transfusion are of an extended phenotype match (particularly D, C, c, E, e, or K). If the RBC unit(s) used for transfusion were not matched for extended phenotype D, C, c, E, e, or K or it is unknown if matched, report No or Unknown, respectively.
Questions 57 – 58: Were RBC alloantibodies present?
The presence of RBC alloantibodies may cause serologic incompatibility and make the selection of RBC units for future transfusions difficult. RBC alloantibodies are typically present once alloimmunization has occurred.
If RBC alloantibodies are present prior to the start of the preparative regimen / infusion, report Yes and specify the number of alloantibodies identified. If testing for RBC alloantibodies were performed multiple times prior to the start of the preparative regimen / infusion, report the most recent assessment.
If RBC alloantibodies were not present prior to the start of the preparative regimen / infusion, report No and continue with Direct bilirubin.
Report Unknown if testing was not performed, or it is not known if alloantibodies were present and continue with Direct bilirubin.
Questions 59 – 60: Does the recipient have donor-specific antibodies present to the donor chosen for transplant? (Mean fluorescence intensity (MFI) > 1000 for HLA-A, HLA-B, and DRB1; and MFI > 2000 for HLA-C, DQB1, and DPB1 or positive virtual cross match)
Mean fluorescence intensity (MFI) is often used to determine the mean intensity and level of antibody expression within a sample. Donor-specific antibodies may be quantified through fluorescing techniques such as flow cytometry. This information may be found on an HLA report or within the blood bank section of the medical record.
Report Yes if the MFI > 1000 for HLA-A, HLA-B, and DRB1 or MFI > 2000 for HLA-C, DQB1, and DPB1 at any time prior to the start of the preparative regimen / infusion. If Yes, indicate if measures were taken to lower the MFI for the presence of donor antibodies prior to the start of the preparative regimen / infusion.
If testing was performed multiple times prior the start of the preparative regimen / infusion, report the most recent assessment.
Report No if the MFI ≤ 1000 for HLA-A, HLA-B, and DRB1 or MFI ≤ 2000 for HLA-C, DQB1, and DPB1 at any time prior to the start of the preparative regimen / infusion.
If testing was not performed to determine presence or absence of donor-specific antibodies, indicate Not tested. The Unknown option should be used sparingly and only when no information is available to determine if donor-specific antibody testing was conducted at any time between diagnosis and the start of the preparative regimen / infusion.
Section Updates:
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