{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T14:35:36Z","timestamp":1784039736087,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,8,3]],"date-time":"2021-08-03T00:00:00Z","timestamp":1627948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Maternal alloantibodies directed against fetal red blood cell (RBC) antigens may cause potentially life\u2010threatening haemolytic disease of the fetus and newborn (HDFN). Dutch transfusion guidelines therefore prescribe preventive cEK matching for all (pre\u2010)fertile females. To quantify the impact of cEK matching, we compared overall and antigen\u2010specific cumulative RBC alloimmunisation incidences in females and males aged &lt;45\u2009years. Among a multicentre cohort comprised of patients who received their first and subsequent RBC unit between 2005 and 2019, first\u2010formed RBC alloantibodies were detected in 47 of 2998 (1\u00b76%) females and 49 of 2507 (2\u00b70%) males. Comparing females and males, overall alloimmunisation incidences were comparable (3\u00b71% [95% confidence interval (CI) 2\u00b71\u20134\u00b74] <jats:italic>versus<\/jats:italic> 3\u00b75% (95% CI 2\u00b74\u20134\u00b79, <jats:italic>P<\/jats:italic>\u2009=\u20090\u00b7853) after 10\u2009units transfused). However, cEK alloimmunisation incidences were significantly lower among females (0\u00b76% (95% CI 0\u00b73\u20131.5) <jats:italic>versus<\/jats:italic> 2\u00b72% (95% CI 1\u00b75\u20133\u00b74, <jats:italic>P<\/jats:italic>\u2009=\u20090\u00b7001) after 10\u2009units transfused). Yet, despite cEK\u2010matching guidelines being in effect, 6\u00b75%, 3\u00b76% and 0\u00b72% of all RBC units remained mismatched for c, E or K antigens respectively. Most of these mismatches were almost always due to emergency settings. Even though cEK alloimmunisation was not prevented completely, implementation of cEK matching resulted in an alloantigen\u2010exposure risk reduction of up to 98%.<\/jats:p>","DOI":"10.1111\/bjh.17697","type":"journal-article","created":{"date-parts":[[2021,8,4]],"date-time":"2021-08-04T01:28:56Z","timestamp":1628040536000},"page":"604-611","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["The effect of extended c, E and K matching in females under 45\u2009years of age on the incidence of transfusion\u2010induced red blood cell alloimmunisation"],"prefix":"10.1111","volume":"195","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8985-6627","authenticated-orcid":false,"given":"Josine A.","family":"Oud","sequence":"first","affiliation":[{"name":"Center for Clinical Transfusion Research Sanquin Research Leiden the Netherlands"},{"name":"Department of Haematology Leiden University Medical Center Leiden the Netherlands"},{"name":"Department of Clinical Epidemiology Leiden University Medical Center Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2122-4682","authenticated-orcid":false,"given":"Dorothea","family":"Evers","sequence":"additional","affiliation":[{"name":"Department of Haematology Radboud University Medical Center Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masja","family":"de Haas","sequence":"additional","affiliation":[{"name":"Center for Clinical Transfusion Research Sanquin Research Leiden the Netherlands"},{"name":"Department of Haematology Leiden University Medical Center Leiden the Netherlands"},{"name":"Department of Immunohaematology Diagnostics Sanquin Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen M. K.","family":"de Vooght","sequence":"additional","affiliation":[{"name":"Central Diagnostic Laboratory University Medical Center Utrecht Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daan","family":"van de Kerkhof","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry and Haematology Catharina Hospital Eindhoven the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nel","family":"Som","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry Amsterdam University Medical Center Location VUmc Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie C. V.","family":"P\u00e9qu\u00e9riaux","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry and Haematology Jeroen Bosch Hospital \u2018s\u2010Hertogenbosch the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisca","family":"Hudig","sequence":"additional","affiliation":[{"name":"LabWest Haga Teaching Hospital The Hague the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjan","family":"Albersen","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry and Laboratory Medicine Leiden University Medical Center Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna G.","family":"van der Bom","sequence":"additional","affiliation":[{"name":"Center for Clinical Transfusion Research Sanquin Research Leiden the Netherlands"},{"name":"Department of Clinical Epidemiology Leiden University Medical Center Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaap Jan","family":"Zwaginga","sequence":"additional","affiliation":[{"name":"Center for Clinical Transfusion Research Sanquin Research Leiden the Netherlands"},{"name":"Department of Haematology Leiden University Medical Center Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,8,3]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.12265"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmrv.2016.05.008"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2007.01625.x"},{"key":"e_1_2_8_5_1","first-page":"484","article-title":"Improving the management and outcome in haemolytic disease of the foetus and newborn","volume":"11","author":"Lopriore E","year":"2013","journal-title":"Blood Transfus"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.15631"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.13977"},{"key":"e_1_2_8_8_1","unstructured":"CBO Blood Transfusion Guideline.2011. English version accessible at:http:\/\/www.isbtweb.org\/fileadmin\/user_upload\/blood\u2010transfusion\u2010guideline.pdf."},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.16276"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2012-001150"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(16)30019-9"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2007.01468.x"},{"key":"e_1_2_8_13_1","volume-title":"The Blood Group Antigen Factsbook","author":"Reid ME","year":"2004"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.16405"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmrv.2018.07.003"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V124.21.4297.4297"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V96.10.3369"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.2001.41091086.x"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.13347"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.13111"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmrv.2011.12.001"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2016.152074"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.12639"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.14307"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2016.162685"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.16166"},{"key":"e_1_2_8_27_1","unstructured":"TRIX register.Dutch transfusion register for irregular antibodies. 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