{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T12:48:34Z","timestamp":1747658914202,"version":"3.40.5"},"reference-count":40,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T00:00:00Z","timestamp":1725840000000},"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":["Transfusion"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hemolytic disease of the fetus and newborn (HDFN) is caused by maternal alloantibody\u2010mediated destruction of fetal\/neonatal red blood cells (RBCs). While the pathophysiology has been well\u2010characterized, the clinical and laboratory monitoring practices are inconsistent.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We surveyed 103 US institutions to characterize laboratory testing practices for individuals with fetuses at risk of HDFN. Questions included antibody testing and titration methodologies, the use of critical titers, paternal and cell\u2010free fetal DNA testing, and result reporting and documentation practices.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The response rate was 44% (45\/103). Most respondents (96%, 43\/45) assess maternal antibody titers, primarily using conventional tube\u2010based methods only (79%, 34\/43). Among respondents, 51% (23\/45) rescreen all individuals for antibodies in the third trimester, and 60% (27\/45) perform paternal RBC antigen testing. A minority (27%, 12\/45) utilize cell\u2010free fetal DNA (cffDNA) testing to predict fetal antigen status. Maternal antibody titers are performed even when the fetus is <jats:italic>not considered to be at risk<\/jats:italic> of HDFN based on cffDNA or paternal RBC antigen testing at 23% (10\/43) of sites that assess titers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>There is heterogeneity across US institutions regarding the testing, monitoring, and reporting practices for pregnant individuals with fetuses at risk of HDFN, including the use of antibody titers in screening and monitoring programs, the use of paternal RBC antigen testing and cffDNA, and documentation of fetal antigen results. Standardization of laboratory testing protocols and closer collaboration between the blood bank and transfusion medicine service and the obstetric\/maternal\u2010fetal medicine service are needed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.18011","type":"journal-article","created":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T13:21:31Z","timestamp":1725888091000},"page":"1870-1880","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Characterization of blood bank and transfusion medicine practices for pregnant individuals with fetuses at risk of hemolytic disease in the <scp>United States<\/scp>"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5719-9685","authenticated-orcid":false,"given":"Jeremy W.","family":"Jacobs","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine and Pathology Mayo Clinic  Rochester Minnesota USA"},{"name":"Department of Pathology, Microbiology, &amp; Immunology Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8422-9480","authenticated-orcid":false,"given":"Garrett S.","family":"Booth","sequence":"additional","affiliation":[{"name":"Department of Pathology, Microbiology, &amp; Immunology Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5028-8426","authenticated-orcid":false,"given":"Kenneth J.","family":"Moise","sequence":"additional","affiliation":[{"name":"Department of Women's Health, Dell Medical School University of Texas at Austin  Austin Texas USA"},{"name":"Comprehensive Fetal Care Center Dell Children's Medical Center  Austin Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9480-2762","authenticated-orcid":false,"given":"Brian D.","family":"Adkins","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7896-2459","authenticated-orcid":false,"given":"Sara","family":"Bakhtary","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine University of California San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8877-956X","authenticated-orcid":false,"given":"Ross M.","family":"Fasano","sequence":"additional","affiliation":[{"name":"Center for Transfusion and Cellular Therapies, Department of Pathology and Laboratory Medicine Emory University School of Medicine  Atlanta Georgia USA"},{"name":"Aflac Cancer and Blood Disorders Center Children's Healthcare of Atlanta  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9653-9905","authenticated-orcid":false,"given":"Ruchika","family":"Goel","sequence":"additional","affiliation":[{"name":"Corporate Medical Affairs Vitalant National Office  Scottsdale Arizona USA"},{"name":"Division of Transfusion Medicine, Department of Pathology Johns Hopkins University School of Medicine  Baltimore Maryland USA"},{"name":"Division of Hematology\/Oncology, Department of Internal Medicine and Pediatrics Simmons Cancer Institute at SIU School of Medicine  Springfield Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah D.","family":"Hinton","sequence":"additional","affiliation":[{"name":"Department of Pathology, Microbiology, &amp; Immunology Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sadia A.","family":"Laghari","sequence":"additional","affiliation":[{"name":"Department of Pathology, Microbiology, &amp; Immunology Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9101-9326","authenticated-orcid":false,"given":"Laura D.","family":"Stephens","sequence":"additional","affiliation":[{"name":"Department of Pathology University of California San Diego  La Jolla California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1785-2245","authenticated-orcid":false,"given":"Christopher A.","family":"Tormey","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1910-2800","authenticated-orcid":false,"given":"Elizabeth P.","family":"Crowe","sequence":"additional","affiliation":[{"name":"Division of Transfusion Medicine, Department of Pathology Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8181-9517","authenticated-orcid":false,"given":"Evan M.","family":"Bloch","sequence":"additional","affiliation":[{"name":"Division of Transfusion Medicine, Department of Pathology Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5526-966X","authenticated-orcid":false,"given":"Elizabeth A.","family":"Abels","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Yale School of Medicine  New Haven Connecticut USA"},{"name":"Department of Pathology and Immunology Baylor College of Medicine  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,9,9]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_9_2_1","DOI":"10.1186\/s12884-022-05329-z"},{"doi-asserted-by":"publisher","key":"e_1_2_9_3_1","DOI":"10.1016\/j.xagr.2023.100203"},{"doi-asserted-by":"publisher","key":"e_1_2_9_4_1","DOI":"10.1111\/vox.12265"},{"doi-asserted-by":"publisher","key":"e_1_2_9_5_1","DOI":"10.1097\/aog.0b013e31826d7dc1"},{"doi-asserted-by":"publisher","key":"e_1_2_9_6_1","DOI":"10.1111\/trf.17548"},{"doi-asserted-by":"publisher","key":"e_1_2_9_7_1","DOI":"10.1007\/s12288-020-01253-4"},{"doi-asserted-by":"publisher","key":"e_1_2_9_8_1","DOI":"10.1111\/trf.15154"},{"doi-asserted-by":"publisher","key":"e_1_2_9_9_1","DOI":"10.1542\/neo.14-2-e83"},{"doi-asserted-by":"publisher","key":"e_1_2_9_10_1","DOI":"10.2147\/jbm.S385737"},{"doi-asserted-by":"publisher","key":"e_1_2_9_11_1","DOI":"10.1111\/j.1537-2995.2005.00629_1.x"},{"doi-asserted-by":"publisher","key":"e_1_2_9_12_1","DOI":"10.2147\/ijwh.S15165"},{"doi-asserted-by":"publisher","key":"e_1_2_9_13_1","DOI":"10.1371\/journal.pone.0235807"},{"doi-asserted-by":"publisher","key":"e_1_2_9_14_1","DOI":"10.1016\/j.siny.2008.02.007"},{"doi-asserted-by":"publisher","key":"e_1_2_9_15_1","DOI":"10.1097\/aog.0000000000002528"},{"doi-asserted-by":"publisher","key":"e_1_2_9_16_1","DOI":"10.1093\/ajcp\/aqad083"},{"doi-asserted-by":"publisher","key":"e_1_2_9_17_1","DOI":"10.1016\/j.tmrv.2023.150810"},{"unstructured":"Royal College of Obstetricians & Gynaecologists.The management of women with red cell antibodies during pregnancy (Green\u2010top Guideline No. 65). 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