Jeremy W Jacobs, Arwa Z Al-Riyami, Jeannie Callum, Meghan Delaney, David Daniel, Jenny White, Christopher Bocquet, Mohammed Farouk, Claude Tayou, Chinelo P Onyenekwu, Kristina Prus, Divjot Singh Lamba, Julie Makani, Quentin Eichbaum, Luiz Amorim, Silvano Wendel, France Pirenne, Vernon Louw, Evan M Bloch
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引用次数: 0
Abstract
Background: Sickle cell disease (SCD) affects over 7 million people globally, with blood transfusion remaining a cornerstone of management. However, contemporary transfusion practices across diverse settings remain poorly characterized. We evaluated global transfusion practices for patients with SCD to identify gaps and inform resource prioritization.
Study design and methods: We conducted a cross-sectional web-based survey of clinicians and laboratory professionals providing transfusion support for SCD, distributed via email using three professional society's membership lists (July-September 2025). Variables included facility characteristics, pre-transfusion testing capabilities, antigen-matching strategies, transfusion modalities, and barriers to care, stratified by World Bank income classification.
Results: After excluding incomplete/duplicate responses, 102 facilities from 39 countries were analyzed; 95 actively treated patients with SCD. Facilities were predominantly public (73%), with 46% in lower-middle-income countries (LMICs). Routine newborn screening was performed by 33% overall (48% high-income countries [HICs] vs. 0% low-income). While ABO/RhD typing was nearly universal, antibody screening was available in only 72% of facilities (0% low-income, 47% LMICs, 98% HICs). Prophylactic RBC antigen matching was performed by 46% (18% LMICs vs. 70% HICs), primarily limited to Rh(CcEe) and K. Automated RBC exchange was available in 44% overall (0% low-income, 25% LMICs, 73% HICs); among facilities with exchange capability, 83% of HICs versus 36% of LMICs could provide exchange within 24 h for acute indications.
Discussion: Pronounced income-related disparities exist in SCD transfusion support. Facilities in lower-income settings disproportionately lack antibody testing, prophylactic matching, and timely automated exchange. Targeted infrastructure investment and context-appropriate guidelines are essential for equitable care.
期刊介绍：
TRANSFUSION is the foremost publication in the world for new information regarding transfusion medicine. Written by and for members of AABB and other health-care workers, TRANSFUSION reports on the latest technical advances, discusses opposing viewpoints regarding controversial issues, and presents key conference proceedings. In addition to blood banking and transfusion medicine topics, TRANSFUSION presents submissions concerning patient blood management, tissue transplantation and hematopoietic, cellular, and gene therapies.
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