Algorithm of Shirey et al for Prophylactic Antigen-Matched Donor Blood for Transfusing a Patient with a Warm Autoantibody

 

Donor blood selected for transfusion should be:

(1) matched for the patient's ABO and D type

(2) negative for known alloantibodies

(3) negative for alloantibodies detected after allogeneic adsorption (this step is not necessary if the patient's complete phenotype is known)

(4) matched for other important antigens (see below)

 

There are 3 options for matching other antigens:

(1) match the complete phenotype of the patient

(2) match as much of the phenotype of the patient as is known

(3) at a minimum be E and K antigen negative

 

Complete phenotype:

(1) C, E, c, and e

(2) K

(3) Jka and Jkb

(4) Fya and Fyb

(5) S and s

 

Leukopoor blood should be transfused to reduce the risk of a febrile reaction that might be mistaken for a hemolytic transfusion reaction.