Blood Bank Guy Essentials Podcast 030: Antibodies in Sickle Cell with Eric Gehrie
Apr 10, 2017
Dr. Eric Gehrie, an associate director of transfusion medicine at Johns Hopkins, dives into the complexities of sickle cell disease and its implications for blood transfusion. He reveals how a single amino acid can affect patient outcomes. The conversation highlights the challenges of alloimmunization and the vital need for genetic and serological matching. Eric emphasizes the global scope of sickle cell management, touches on emerging treatments like gene therapy, and shares his passion for safety in transfusion practices, making for an engaging discussion.
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Sickle Cell Patients Alloimmunize Much More
- Patients with sickle cell disease alloimmunize at much higher rates than the general transfused population.
- Expect ~30% or more to have antibodies versus <5% in a mixed transfused population.
Alloimmunization Risk Is Multifactorial And Unpredictable
- Multiple factors (genetics, inflammation, HLA, transfusion history) likely drive alloimmunization risk.
- No current test reliably predicts who will become a strong responder.
Serologic Matching Helps But Has Limits
- Serologic antigen matching can reduce some alloimmunization but has inconsistent population impact.
- Costs and limited accuracy make broad serologic matching controversial.