{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T05:05:42Z","timestamp":1784005542731,"version":"3.55.0"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Recipient alloimmunization remains the most frequent adverse effect of transfusion therapy. Routine transfusion decisions rely heavily on clinician judgment and informal rules, which limit consistency and reproducibility. Current transfusion decision-making practices do not systematically integrate patient-specific clinical and immunohematologic factors, phenotype-level requirements, and inventory constraints within a coherent framework. This study introduces a recipient-centered integrative model that unifies patient-group\u2013based matching criteria, quantitative compatibility scoring, and phenotype-based inventory curation to support transfusion practices aimed at reducing alloimmunization risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The ImmunoHematology Framework (IHF) uses demographic, clinical, and laboratory data to define phenotype-based matching requirements. It quantifies recipient\u2013donor compatibility, calculates the degree of phenotype match using all available antigen information, and ranks recipient\u2013unit pairs for selection and allocation. IHF also classifies donor phenotypes to support curation of refrigerated and frozen inventories. The framework was operationally evaluated as an integrated system, including its quantitative compatibility logic, using de-identified operational data and curated demonstration cases across routine and rare scenarios.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The IHF model produced extended phenotype matching outcomes (\u226514 antigens) that demonstrated improved compatibility recommendations compared with clinician selections in the pilot evaluation, with complete agreement in 59% of cases, moderate deviation in 18%, and significant deviation in 23%. Matching 327 fully typed donors to 27 patients requiring extended antigen compatibility revealed a subset with substantially broader compatibility (median 9 vs. 4 recipients), identifying these units as candidates for long-term frozen storage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>IHF formalizes recipient-specific transfusion risk associated with phenotype mismatch and quantitative compatibility as a computable construct the framework demonstrates how its logic, scoring method, donor unit allocation process, and phenotype-based inventory curation can be operationalized in real-world transfusion practice, with reproducibility confirmed by a functioning prototype.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1875496","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T04:21:49Z","timestamp":1784002909000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Quantifying red blood cell compatibility beyond ABO and RhD: a recipient-centered model for matching, allocation, and inventory curation"],"prefix":"10.3389","volume":"13","author":[{"given":"Gennady","family":"Peysakhovich","sequence":"first","affiliation":[{"name":"Independent Consultant, Data Architect\/Modeler","place":["Feasterville, PA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Butina","sequence":"additional","affiliation":[{"name":"Independent Researcher","place":["Kirov, Russia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2559","DOI":"10.1111\/trf.15351","article-title":"A national transfusion register of irregular antibodies and cross (X)-match problems: TRIX, a 10-year analysis","volume":"59","author":"van Gammeren","year":"2019","journal-title":"Transfusion"},{"key":"ref2","volume-title":"SHOT Reports","year":"2026"},{"key":"ref3","volume-title":"Transfusion\/Donation Fatalities","year":"2026"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1821","DOI":"10.1182\/blood-2018-08-833962","article-title":"Transfusion-related red blood cell alloantibodies: induction and consequences","volume":"133","author":"Tormey","year":"2019","journal-title":"Blood"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1111\/trf.12250","article-title":"Cost-effectiveness of prospective red blood cell antigen matching to prevent alloimmunization among sickle cell patients","volume":"54","author":"Kacker","year":"2014","journal-title":"Transfusion"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"2045","DOI":"10.1111\/trf.18412","article-title":"Strategies to mitigate transfusion-associated red blood cell alloimmunization in sickle cell disease: a retrospective analysis","volume":"65","author":"Crowe","year":"2025","journal-title":"Transfusion"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1111\/trf.15002","article-title":"The prevalence, alloimmunization risk factors, antigenic exposure, and evaluation of antigen-matched red blood cells for thalassemia transfusions: a 10-year experience at a tertiary care hospital","volume":"59","author":"Romphruk","year":"2019","journal-title":"Transfusion"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"2040","DOI":"10.1111\/trf.17562","article-title":"Red blood cell alloimmunization in myelodysplastic syndromes: associations with sex, DAT-positivity, and increased transfusion needs","volume":"63","author":"Ryd\u00e9n","year":"2023","journal-title":"Transfusion"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1111\/vox.12455","article-title":"Prophylactic RhCE and Kell antigen matching: impact on alloimmunization in transfusion-dependent patients with myelodysplastic syndromes","volume":"112","author":"Lin","year":"2017","journal-title":"Vox Sang"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"102946","DOI":"10.1016\/j.transci.2020.102946","article-title":"Immunohematologic aspects of alloimmunization and alloantibody detection: a focus on pregnancy and hemolytic disease of the fetus and newborn","volume":"59","author":"Gupta","year":"2020","journal-title":"Transfus Apher Sci"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"150958","DOI":"10.1016\/j.tmrv.2025.150958","article-title":"Five pathogenetic classifications for alloimmune hemolytic disease of the fetus and newborn","volume":"40","author":"Ohto","year":"2026","journal-title":"Transfus Med Rev"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1182\/asheducation-2016.1.446","article-title":"Understanding red blood cell alloimmunization triggers","volume":"2016","author":"Hendrickson","year":"2016","journal-title":"Hematology Am Soc Hematol Educ Program"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"630","DOI":"10.1111\/j.1537-2995.2006.00764.x","article-title":"Additional red blood cell alloantibodies after blood transfusions in a nonhematologic alloimmunized patient cohort: is it time to take precautionary measures?","volume":"46","author":"Schonewille","year":"2006","journal-title":"Transfusion"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1046\/j.1537-2995.1999.39199116889.x","article-title":"Evaluation of methods for detecting alloantibodies underlying warm autoantibodies","volume":"39","author":"Leger","year":"1999","journal-title":"Transfusion"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"5655","DOI":"10.1182\/bloodadvances.2022006982","article-title":"Red cell alloimmunization is associated with increased health care costs, longer hospitalizations, and higher mortality","volume":"6","author":"Viayna","year":"2022","journal-title":"Blood Adv"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1640","DOI":"10.1111\/trf.17966","article-title":"Alloimmunization in myelodysplastic syndrome is associated with higher healthcare costs, longer hospitalizations, and increased mortality","volume":"64","author":"Viayna","year":"2024","journal-title":"Transfusion"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"199","DOI":"10.3389\/fmed.2018.00199","article-title":"A conceptual framework for optimizing blood matching strategies: balancing patient complications against total costs incurred","volume":"5","author":"van Sambeeck","year":"2018","journal-title":"Front Med"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1732","DOI":"10.1111\/j.1537-2995.2010.03045.x","article-title":"Extended red blood cell antigen matching for transfusions in sickle cell disease: a review of a 14-year experience from a single center","volume":"51","author":"Lasalle-Williams","year":"2011","journal-title":"Transfusion"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1599","DOI":"10.1111\/bjh.19740","article-title":"Major reduction in anti-c and anti-E in pregnancy after preventive matched transfusion","volume":"205","author":"Luken","year":"2024","journal-title":"Br J Haematol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"604","DOI":"10.1111\/bjh.17697","article-title":"The effect of extended c, E and K matching in females under 45 years of age on the incidence of transfusion-induced red blood cell alloimmunisation","volume":"195","author":"Oud","year":"2021","journal-title":"Br J Haematol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1111\/tme.12652","article-title":"Low incidence of post-transfusion Kell (KEL1) alloimmunisation in patients under 50 years old","volume":"30","author":"Moncharmont","year":"2020","journal-title":"Transfus Med"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1029","DOI":"10.1111\/vox.13699","article-title":"Transfusion support and pre-transfusion testing in autoimmune haemolytic anaemia","volume":"119","author":"Binsfeld","year":"2024","journal-title":"Vox Sang"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1182\/bloodadvances.2019001143","article-title":"American Society of Hematology 2020 guidelines for sickle cell disease: transfusion support","volume":"4","author":"Chou","year":"2020","journal-title":"Blood Adv"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"e732","DOI":"10.1097\/HS9.0000000000000732","article-title":"2021 Thalassaemia international federation guidelines for the Management of Transfusion-dependent Thalassemia","volume":"6","author":"Farmakis","year":"2022","journal-title":"Hema"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1217","DOI":"10.1111\/trf.17880","article-title":"How do transfusion services manage patients taking therapies such as anti-CD38 and anti-CD47 known to interfere with red blood cell compatibility testing?","volume":"64","author":"Murphy","year":"2024","journal-title":"Transfusion"},{"key":"ref26","volume-title":"National Blood Collection and Utilization Survey Report, 2023","year":"2025"},{"key":"ref27","volume-title":"The 2021 National Blood Collection and Utilization Survey Report","year":"2023"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1111\/trf.16145","article-title":"Maintaining adequate donations and a sustainable blood supply: lessons learned","volume":"61","author":"Gammon","year":"2021","journal-title":"Transfusion"},{"key":"ref29","first-page":"29","article-title":"Real-world utilization of daratumumab in the United States: treatment patterns and patient characteristics","volume":"136","author":"Chari","year":"2020","journal-title":"Blood"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1111\/bjh.19664","article-title":"Blood group genotype matching for transfusion","volume":"206","author":"Westhoff","year":"2025","journal-title":"Br J Haematol"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1111\/tme.12887","article-title":"Mapping anticipated advantages and disadvantages of implementation of extensive donor genotyping: a focus group approach","volume":"32","author":"Luken","year":"2022","journal-title":"Transfus Med"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"2054","DOI":"10.1111\/trf.16425","article-title":"Optimizing transfusion management of multiple myeloma patients receiving daratumumab-based regimens","volume":"61","author":"Phou","year":"2021","journal-title":"Transfusion"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1111\/tme.12808","article-title":"Alloimmunisation rate of patients on daratumumab: a retrospective cohort study of patients in England","volume":"31","author":"Bullock","year":"2021","journal-title":"Transfus Med"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1111\/tme.12831","article-title":"Extended red blood cell matching for all transfusion recipients is feasible","volume":"32","author":"van Sambeeck","year":"2022","journal-title":"Transfus Med"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1287\/msom.2017.0650","article-title":"Threshold-based allocation policies for inventory management of red blood cells","volume":"20","author":"Sarhangian","year":"2018","journal-title":"Manuf Serv Oper Manag"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1111\/trf.16739","article-title":"From demand forecasting to inventory ordering decisions for red blood cells through integrating machine learning, statistical modeling, and inventory optimization","volume":"62","author":"Li","year":"2022","journal-title":"Transfusion"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1007\/s10479-022-04930-x","article-title":"Robust possibilistic programming to design a closed-loop blood supply chain network considering service-level maximization and lateral resupply","volume":"328","author":"Momenitabar","year":"2022","journal-title":"Ann Oper Res"},{"key":"ref38","volume-title":"Comprehensive Red Blood cell Matching. PhD Dissertation","author":"van de Weem","year":"2020"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1016\/j.ejor.2021.02.054","article-title":"Optimal blood issuing by comprehensive matching","volume":"296","author":"van Sambeeck","year":"2022","journal-title":"Eur J Oper Res"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1111\/vox.13217","article-title":"Preventing alloimmunization using a new model for matching extensively typed red blood cells","volume":"117","author":"van de Weem","year":"2022","journal-title":"Vox Sang"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1111\/vox.13594","article-title":"Extensive red blood cell matching considering patient alloimmunization risk","volume":"119","author":"Wemelsfelder","year":"2024","journal-title":"Vox Sang"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"e284","DOI":"10.1016\/S2352-3026(16)30019-9","article-title":"Red-blood-cell alloimmunisation in relation to antigens\u2019 exposure and their immunogenicity: a cohort study","volume":"3","author":"Evers","year":"2016","journal-title":"Lancet Haematol"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"659","DOI":"10.1111\/trf.17307","article-title":"The need for rare blood programs is real","volume":"63","author":"Lomas-Francis","year":"2023","journal-title":"Transfusion"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"582","DOI":"10.1111\/trf.15027","article-title":"Modeling rare blood in Canada","volume":"59","author":"Blake","year":"2019","journal-title":"Transfusion"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"357","DOI":"10.17816\/cld679562","article-title":"Method for assessing the immunogenicity of blood group antigens and clinical significance of erythrocyte antibodies","volume":"69","author":"Butina","year":"2024","journal-title":"Klin Lab Diagn"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1875496\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T04:21:52Z","timestamp":1784002912000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1875496\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,14]]},"references-count":45,"alternative-id":["10.3389\/fmed.2026.1875496"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1875496","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,14]]},"article-number":"1875496"}}