{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T10:46:24Z","timestamp":1788345984213,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,1,26]],"date-time":"2024-01-26T00:00:00Z","timestamp":1706227200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Red blood cell alloimmunization and consequent delayed hemolytic transfusion reaction (DHTR) incidence and mortality in patients with sickle cell disease (SCD) are high. A shared transfusion resource has decreased both in other countries, while in the United States cost concerns persist. We conducted a Markov cohort simulation of a birth cohort of alloimmunized patients with SCD to estimate lifetime DHTR incidence, DHTR\u2010specific mortality, quality\u2010adjusted life expectancy (QALE), and costs with the implementation of a shared transfusion resource to identify antibody history versus without (i.e., status quo). We conducted our analysis using a lifetime analytic time horizon and from a United States health system perspective. Implementation of shared transfusion resource projects to decrease cumulative DHTR\u2010specific mortality by 26% for alloimmunized patients with SCD in the United States, relative to the status quo. For an average patient population of 32\u2009000, this intervention would generate a discounted increment of 4000 QALYs at an incremental discounted cost of $0.3 billion, resulting in an incremental cost\u2010effectiveness ratio of $75\u2009600\/QALY [95% credible interval $70 200\u201381\u2009400\/QALY]. The results are most sensitive to the baseline lifetime medical expenditure of patients with SCD. Alloantibody data exchange is cost\u2010effective in 100% of 10\u2009000 Monte Carlo simulations. The resource would theoretically need a minimum patient population of 1819 patients or cost no more than $5.29 million annually to be cost\u2010effective. By reducing DHTR\u2010specific mortality, a shared transfusion resource in the United States projects to be a life\u2010saving and cost\u2010effective intervention for patients with SCD in the United States.<\/jats:p>","DOI":"10.1002\/ajh.27211","type":"journal-article","created":{"date-parts":[[2024,1,27]],"date-time":"2024-01-27T06:59:13Z","timestamp":1706338753000},"page":"570-576","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Decreasing alloimmunization\u2010specific mortality in sickle cell disease in the United States: Cost\u2010effectiveness of a shared transfusion resource"],"prefix":"10.1002","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4430-1860","authenticated-orcid":false,"given":"Satoko","family":"Ito","sequence":"first","affiliation":[{"name":"Section of Hematology, Department of Internal Medicine Yale University School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6130-2286","authenticated-orcid":false,"given":"Ankur","family":"Pandya","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management Harvard T.H. Chan School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7361-7162","authenticated-orcid":false,"given":"Ronald G.","family":"Hauser","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Yale University School of Medicine  New Haven Connecticut USA"},{"name":"Department of Pathology and Laboratory Medicine VA Connecticut Healthcare System  West Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3242-0037","authenticated-orcid":false,"given":"Lakshmanan","family":"Krishnamurti","sequence":"additional","affiliation":[{"name":"Section of Pediatric Hematology, Oncology and Bone Marrow Transplant, Department of Pediatrics Yale University School of Medicine  New Haven Connecticut 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