While individuals with the sickle cell trait (SCT) have a single allele of hemoglobin S (HbS) and are eligible blood donors, their RBCs may sickle under certain conditions. Thus, many transfusion services screen RBC units to avoid transfusing SCT RBCs to individuals with sickle cell disease (SCD) and neonates. The clinical necessity of SCT screening, however, is unclear. To better understand the practice of SCT screening in Canada, researchers audited a children’s hospital in 2018 in Toronto that follows >1000 children with sickle cell disease annually. The hospital screened 2268 RBC units for SCT that were selected for transfusion to patients with SCD and neonates. Only one unit tested positive for SCT which was diverted back to the general inventory. Based on modeling in children of different ages, transfusing a single unit of SCT minimally impacts HbS%. Furthermore, researchers found variable testing strategies for SCT from a survey conducted at 13 Canadian hospitals. Four hospitals did not screen for SCT, four performed SCT screening for children with SCD, and six performed SCT screening for neonates. Further research is needed to determine if screening for SCT is clinically necessary.
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