Screening for RBC antibodies— what should we expect from antibody detection RBCs

In the United States, the Food and Drug Administration mandates that red blood cells (RBCs) for antibody detection possess the following antigens: C, D, E, c, e, M, N, S, s, P₁,Le^a,Le^b,K,k,Fy^a,Fy^b,Jk^a, and Jk^b. Although not required, it is generally agreed that homozygosity for C,D,E,c,e,Fy^a,and Jk^a is also preferable.There is no requirement for low-frequency antigens to be present.However, manufacturers of antibody detection RBCs receive requests for these RBCs to possess C^w,Kp^a,and Wr^a.There are no data to support the considerable expense and effort involved in providing RBCs that possess low-frequency antigens such as C^w, Kp^a, and Wr^a. The risk of clinically-significant hemolytic transfusion reactions occurring when such antibodies are not detected because antibody detection RBCs lack such antigens is about 1 in 500,000 to 1 in 1 million transfusions. Immunohematology 2002;18:71–77.