American Red Cross Pitman, New Jersey, United States
Background/Case Studies: The American Rare Donor Program (ARDP) receives numerous requests from member Immunological Reference Laboratories (IRLs) for rare blood products for alloimmunized patients. ARDP collaborates with the International Rare Donor Panel (IRDP) in the United Kingdom and other rare donor programs around the world. The ARDP has facilitated the export of rare blood products to international partners since 2008. The aim of this study was to determine the number and percent of all requests that were from outside of the US and the phenotype classes of these requests as well as to review the country of origin of these requests. The goal of the study is to better understand the unmet need of specific rare blood phenotypes across the globe.
Study
Design/Methods: A query of the ARDP donor database was performed to identify requests for rare blood from outside of the US from calendar year 2008 through 2022. Each request was evaluated for country of origin, phenotype, number of units requested, and whether the request was fulfilled or canceled. The data was evaluated compared to the total requests received each year.
Results/Findings: During the time period of 2008-2022, the ARDP received nearly 14,000 requests for rare blood products. Of these, 85 requests (0.61%) were from outside of the US. The number of requests from outside of the US per year ranged from a low of 2 (0.2% in 2018) to a high of 10 (1.3% in 2018). A total of 154 rare blood products were exported during this period with annual exports ranging from 4 to 17 units per year. There were requests for high-prevalence antigen negative red cell units each year of the study period while there were requests for red cells lacking multiple common antigens each year from 2011-2019. There were requests for RH allele-matched red cells in 2018, 2020 and 2022. There were no requests for IgA-deficient blood products during this period. Requests for rare blood products were received from 13 different countries during this time period. The ARDP received requests from 2 to 6 countries per year, with the most requests coming from Canada with at least one request each year except for in 2008. Conclusions: Requests for rare blood received by the ARDP from outside of the US inform the broader rare donor community of the unmet needs of alloimmunized patients across the world. The requests were for red cell units lacking high prevalence antigens, multiple common antigens and more recently RH allele matched units. The fulfillment of these requests by the ARDP underscores the program’s large and diverse donor pool and geographic reach. These findings demonstrate the ARDP’s commitment to collaborate with blood suppliers around the globe to meet the needs of patients requiring rare blood products.
Importance of research: The analysis of the number of times requests for rare blood come from outside of the United States, from where and for what products, helps inform the rare donor community including Immunohematology Reference Laboratories regarding what types are needed. It also provides a context for the global blood supplier community that could be used to strategically screen for specific types to better meet patient need.
