Frye Victoria, Caltabiano Melinda, Kessler Debra A, Schaffler Harvey, Reboza Mark, Hillyer Christopher D, Shaz Beth H
Laboratory of Social and Behavioral Sciences, New York Blood Center, New York, New York; Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York.
Transfusion. 2014 Dec;54(12):3061-7. doi: 10.1111/trf.12767. Epub 2014 Jul 2.
Individuals with sickle cell disease (SCD), thalassemia, and leukemia often require frequent transfusion and run the risk of red blood cell (RBC) alloimmunization. To prevent alloimmunization or when alloimmunization is present, phenotype-matched and antigen-negative RBCs are transfused. To increase the probability of a phenotypic match, donors and recipients should share the same racial and/or ethnic background. Because the majority of patients with SCD are of African and Hispanic or Latino descent, a donor base of racial and ethnic minority donors providing an adequate supply of antigen-negative RBC units that can be phenotypically matched is required to meet the needs of frequently transfused patients.
The New York Blood Center began the PreciseMatch program in 2005 to increase donations among African American and Hispanic/Latino donors by 150 incremental units per month. To evaluate the program, we conducted a systematic analysis of program documentation, focus group results, and collections data by race and ethnicity over time.
The program achieved 75% of the operationalized goal of a 150-unit-per-month increase; 75% of donors were first-time donors, with deferral rates at new drives as high as 50%. Significant time and effort was involved in cultivating the community connections that facilitated new drives.
Although PreciseMatch fell short of targets, it served as a foundation for relationships with diverse communities. Further research is needed to understand better how to increase minority donation using existing infrastructure and in the face of market pressures to collect blood as efficiently as possible.
镰状细胞病(SCD)、地中海贫血和白血病患者通常需要频繁输血,存在红细胞(RBC)同种免疫的风险。为预防同种免疫或在存在同种免疫时,会输注血型匹配且抗原阴性的红细胞。为提高血型匹配的概率,供者和受者应具有相同的种族和/或族裔背景。由于大多数SCD患者为非洲裔、西班牙裔或拉丁裔血统,因此需要一个由少数族裔供者组成的供者库,以提供足够数量的可进行血型匹配的抗原阴性红细胞单位,来满足频繁输血患者的需求。
纽约血液中心于2005年启动了精准匹配项目,目标是每月增加非裔美国人和西班牙裔/拉丁裔供者的献血量150个单位。为评估该项目,我们对项目文档、焦点小组结果以及不同时间按种族和族裔分类的采血数据进行了系统分析。
该项目实现了每月增加150个单位这一可操作目标的75%;75%的供者为首次献血者,新的采血活动中的延期率高达50%。建立促进新采血活动的社区联系需要投入大量时间和精力。
尽管精准匹配项目未达到目标,但它为与不同社区建立关系奠定了基础。需要进一步开展研究,以更好地了解如何利用现有基础设施增加少数族裔献血量,同时应对尽可能高效采血的市场压力。