A national Transfusion Register of Irregular Antibodies and Cross (X)-match Problems: TRIX, a 10-year analysis

BACKGROUND: The Transfusion Register of Irregular Antibodies and Cross-match Problems (TRIX) is a unique national database in the Netherlands that was launched in 2007. Transfusion laboratories register the presence of irregular RBC alloantibodies for their patients and can consult the database for information that is relevant for pretransfusion testing, unknown in their own laboratory information system. STUDY DESIGN AND METHODS: Data from the TRIX database 10 years after implementation have been analyzed to demonstrate the added value of TRIX for transfusion practice. TRIX antibody registration, antibody disappearance likelihood, and differences between men and women have been analyzed and evaluated. RESULTS: In the 10-year period 2007 to 2016, a total of 80,164 alloantibodies have been identified and registered in 62,110 individuals. Of the antibodies, 81% were reported in women and 19% in men (female:male, 4.3:1). Rh (DCcEe and C w), K, Fy a, and Jk a antibodies account for 65.6% of all antibody registrations. M and Lewis antibodies account for 18.6% of all antibodies. Antibody disappearance likelihood is relatively high for the clinically relevant antibodies directed against Jk b, s, Fy b, and e. Antibodies directed against D, Fy a, and K have a relatively low antibody disappearance likelihood. CONCLUSION: TRIX is a unique and useful tool for transfusion laboratories for timely and up-to-date information on the presence of erythrocyte antibodies, which improves pretransfusion testing and compatible blood selection. TRIX also provides macro data on the prevalence of individual antibodies and antibody disappearance likelihoods that can be used for developing blood type matching strategies for patient groups at risk

Clinical and in vitro evaluation of red blood cells collected and stored in a non-DEHP plasticized bag system

Background and Objectives: Di-ethyl-hexyl-phthalate (DEHP) is currently the main plasticizer used for whole blood collection systems. However, in Europe, after May 2025, DEHP may no longer be used above 0.1% (w/w) in medical devices. DEHP stabilizes red cell membranes, thereby suppressing haemolysis during storage. Here we compared in vitro quality parameters of red cell concentrates (RCCs) collected and stored in DEHP-, DINCH- or DINCH/BTHC-PVC hybrid blood bags with saline-adenine-glucose-mannitol (SAGM) or phosphate-adenine-glucose-guanosine-saline-mannitol (PAGGSM) storage solution. Last, we performed haemovigilance surveillance for RCC collected in DINCH-PVC and stored in PAGGSM/BTHC-PVC. Materials and Methods: In vitro quality parameters of RCC were determined during 42 days of storage. Haemovigilance surveillance was conducted to compare the frequency and type of transfusion reaction. Results: Haemolysis levels were increased in SAGM/BTHC-PVC as compared to SAGM/DEHP-PVC (0.66% ± 0.18% vs. 0.36% ± 0.17%). PAGGSM storage solution was able to adequately suppress haemolysis to levels observed during storage in SAGM/DEHP-PVC, both in BTHC-PVC (0.38% ± 0.12%), and to a slightly lesser extent in DINCH-PVC (0.48% ± 0.17%). A total of 1650 PAGGSM/BTHC-PVC and 5662 SAGM/DEHP-PVC RCC were transfused yielding a transfusion reaction frequency of 0.24% (95% CI 0.0000–0.0048) and 0.44% (95% CI 0.0027–0.0061) respectively. Conclusion: The in vitro quality of RCC stored in PAGGSM/BTHC-PVC and SAGM/DEHP-PVC is comparable. There is no indication that transfusion of erythrocytes stored in PAGGSM/BTHC-PVC results in increased transfusion reaction frequency. These initial results provide a basis for further clinical evaluation to narrow down the confidence interval of transfusion reaction frequency