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Transfusion Side-Effects Curbed With New NHS Test

A new NHS test is set to curb transfusion side-effects for thousands with inherited blood disorders, NHS England announced.

A new genetic blood-matching test for thousands living with sickle-cell disease or thalassemia, which could reduce painful side-effects of transfusion treatments, is set to be rolled out by the NHS.

The NHS will become the first healthcare system in the world to provide blood group genotyping to more accurately match those in need of transfusions to donated blood, an NHS England spokesperson said.

Delivered in partnership by NHS England and NHS Blood and Transplant (NHSBT), the new programme will help to ensure patients receive the best treatment for them and will reduce the risk and impact of reactions to donor blood and the development of antibodies that attack the donor blood cells.

Dr Andrea Harmer, NHSBT's genomics programme director, pointed out that the organisation’s work goes "much beyond" just providing donated blood for patients who need transfusions. She explained that it also involved the provision of scientific services to make blood transfusions even safer.

"The new genotyping technology being used in this project was developed by an international consortium of which NHSBT is one of the founding members," she said.

Better Matched Blood

There are around 17,000 people living with sickle cell disease (SCD) in England, with 250 new cases per year. Patients with the disease receive more than 10,000 units of blood per month, NHSBT highlighted.

In England there are about 800 patients with thalassaemia, and fewer than 50 new cases each year.

"The test will also help patients living with other rare inherited anaemias," NHS England said.

SCD is particularly common among people of Black African and Caribbean heritage, while thalassemia is mainly seen in those with an Asian or southern Mediterranean heritage. Up to a fifth of patients (17%) can experience bad side-effects after a transfusion because of inadequately matched blood, as the main source of blood for transfusions is people with European ancestry, explained a NHS England spokesperson. 

These side effects can lead to transfusion reactions and make it difficult to find enough blood for future transfusions. The effects of this can be severe, leading to a patient’s condition deteriorating and, in some very rare cases, it can lead to death.

Although blood is matched to the right blood group, small differences within these blood groups mean the immune system is triggered to produce antibodies to attack the new red blood cells. Blood group genotyping would mean better-matched transfusions with more suitable blood found for patients. 

'Cutting-Edge' Technology

NHS chief executive Amanda Pritchard described the new programme as "fantastic" and said that it would "hugely" boost patients' quality of life.

Health Minister Neil O'Brien believed that the genotyping programme was a potential "game-changer", but warned that more donors from communities where sickle-cell and thalassemia were common were "urgently" needed.

"For people to benefit the most from the testing, there is an ongoing need for more donors of Black and South Asian heritage," highlighted the NHS England spokesperson. 

One patient with SCD commented that he'd been told he was "like a celebrity" because it was so difficult to find matching blood for him. He urged people from the Black community to give blood, as they were "so important" in saving the lives of people with sickle cell.

John James, the Sickle Cell Society's chief executive, was "delighted" with the new programme. "Its use of cutting-edge technology to help reduce the side effects people can experience when they receive a transfusion will make a huge difference for people living with SCD and help tackle the health inequalities," he said.

Progressive Decision Needs Donors to Succeed

A similar programme for donors will eventually result in patients with sickle cell and thalassemia receiving better-matched blood, reducing the development of antibodies, and leading to better care for patients, said NHS England.

It hoped that once a donor database was developed, this would match all patients with sickle cell and thalassemia needing a blood transfusion more accurately.

Roanna Maharaj, UK Thalassaemia Society vice chair, "wholeheartedly" supported the "progressive" decision of offering blood group genotyping to all individuals living with transfusion-dependent thalassaemia in England.

"This new initiative will help ensure individuals living with transfusion-dependent thalassaemia receive blood transfusions that are safer, more effective, and better matched to their needs, to reduce the risk of transfusion reactions and other complications," she celebrated. She added that the Society looked forward to welcoming these changes in Scotland, Wales, and North Ireland.

"Our scientific work can only help patients if we have blood donors and the demand for ethnically matched blood is on the rise," cautioned Dr Harmer, who encouraged people from ethnic communities to register as donors.