Survey of Red Cell Transfusion Therapy and Immunohematology Services for Patients with Hemoglobinopathies in Türkiye

Transfusion therapy is critical for many patients with β-thalassemia or sickle cell disease (SCD). We aimed to review current practices and document chronic transfusion therapy for patients with hemoglobinopathies in the transfusion service centers of Türkiye.

A survey with 16 structured questions was distributed electronically to adult and pediatric hematologists in Türkiye. Responses were received from 37 centers across 18 cities, representing 1449 patients diagnosed with β-thalassemia major, β-thalassemia intermedia, and SCD.

Although 79% of centers reported performing extended red cell antigen typing prior to the first transfusion, adherence to national transfusion guidelines was inconsistent. Only 16% of centers routinely performed indirect antiglobulin testing before each transfusion despite guideline recommendations. Antibody identification capabilities varied, with 26% of centers lacking the capability onsite. Elution and adsorption testing were always performed at 13% of centers only, predominantly including university hospitals. Nearly half of the centers were always able to provide D, C, E, c, e, and Kell compatible red cell units, but one-fourth reported that they were unable to consistently provide compatible units due to limited supply. There was no access to red cell genotyping in the country.

Our survey revealed disparities in transfusion practices and transfusion service laboratory infrastructure across Türkiye. There is a need for national policy initiatives to mandate adherence to national and international guidelines, expand immunohematology testing capabilities, and ensure the equitable distribution of phenotype-matched red cell units. These findings will contribute to discussions on establishing a centralized immunohematology reference laboratory and enabling red cell genotyping within the country to improve transfusion safety and health equity in hemoglobinopathy care.