Implementation and assessment of high-throughput donor typing at the Milan, Italy, immunohematology reference laboratory

In 2005, the Centro Transfusionale e di Immunomatologia, Dipartimento di Medicina Rigenerativa, an Immunohematology Reference Laboratory in Milan, Italy, instituted a rare donor program to address the transfusion needs of patients with complex immunization to red cell antigens with a rare phenotype. From June 2005 to December 2008, the laboratory used a high-productivity system (Galileo, Immucor, Norcross, GA) for mass-scale antigen screening with profile 1 and 2 antigens for select donors, where 48,715 blood donors were typed with the identification of 6,634 rare blood donors. In April 2009, the laboratory adopted the BeadChip™ platform (BioArray Solutions, Ltd., Warren, NJ) for large-scale DNA typing. The decision to implement was to expand the panel of red blood cell and platelet antigens using the human erythrocyte antigen (HEA) and human platelet antigen (HPA) BeadChip™ formats. As recommended by international guidelines, a validation plan was used to evaluate the sensitivity and specificity of the method. The results of our testing are described in this chapter.