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October 20, 2015

Red Blood Cell TransfusionPrecision vs Imprecision Medicine

Author Affiliations
  • 1Department of Transfusion Medicine, National Institutes of Health Clinical Center, National Institutes of Health, Bethesda, Maryland
  • 2Department of Critical Care Medicine, National Institutes of Health Clinical Center, National Institutes of Health, Bethesda, Maryland
JAMA. 2015;314(15):1557-1558. doi:10.1001/jama.2015.10890

In the early 20th century discovery of blood groups led to the first example of “precision medicine.” By matching blood donors with their recipients, personalized therapy improved transfusion safety.1 In the 1960s, the National Institutes of Health (NIH) established a partitioned data set on a mainframe computer with 2700 blood donors phenotyped by serology for 20 red blood cell antigens. Combining mid-20th century genetic typing technology with the emerging field of informatics served to enhance donor-recipient compatibility and red blood cell inventory management. “Extended typing” simplified transfusion for patients with red blood cell antibodies, reduced the risk of future red blood cell alloimmunization, and became standard management for patients with sickle cell disease. However most hospitals faced with transfusion compatibility problems still tried to identify antigen-negative red blood cell units by screening local inventories with inefficient, labor-intensive serologic assays.

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