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Selecting red blood cells for patients with hemoglobinopathies

Why did ICTMG develop a guideline for hemoglobinopathies?

Red blood cell transfusions are a life-sustaining therapy for patients with β-thalassemia or sickle cell disease, but having multiple transfusions puts them at high risk for alloimmunization.  Alloimmunization is a well-documented complication of transfusion that increases the risk of delayed hemolytic transfusion reactions, complicates crossmatching and identifying compatible units, and delays provision of transfusions.

ICTMG's recommendations can help ensure these transfusion patients receive the red cell blood product that is optimal for them.  The guideline is intended for transfusion medicine physicians as well as physicians intending to transfuse patients with hemoglobinopathies and apply to patients who require chronic or isolated red blood cell transfusion.

How to access the ICTMG publication

ICTMG's systematic review and guideline on transfusing red blood cells for patients with hemoglobinopathies was published in Transfusion in 2018:

  • To download a pdf of the article click here:

Sickle cells

Additional resources


The best match - Transfusing patients with hemoglobinopathies

Listen to Dr. Shubha Allard, consultant hematologist, in conversation with Dr. Stella Chou, pediatric hematologist and transfusion medicine specialist, and Dr. Gregory Denomme, clinical scientist.

They discuss red cell matching strategies for patients with hemoglobinopathies: the evidence for selecting antigen-matched red blood cells, matching in resource-limited settings, and how ICTMG’s recommendations can help standardize transfusion practices.

Red cell specifications for patients with hemoglobinopathies:

A systematic review and guideline

Please use or adapt our presentation for educational or training purposes. Download the slide deck here.

Hemoglobinopathies algorithm

Print out the decision-making algorithm summarizing ICTMG’s recommendations for red blood cell transfusion in patients with sickle cell disease and thalassemia syndromes. It can be used by health-care professionals involved in transfusion of patients, clinicians, medical directors of transfusion labs, and medical technologists who provide blood products in hospitals.

Journal Club webcast

View a webcast to learn more about the ICTMG guideline, how to appraise it using AGREE II, and hear from experts in various regions of the world on the applicability of the guidelines to their regions. This webcast was recorded through a partnership with ISBT.

Journal Club objectives:

  • Review the published ICTMG guideline on red cell selection for patients with hemoglobinopathies

  • Preform a critical appraisal of the guideline using the AGREE II tool

  • Discuss the applicability of the guideline in different regions



  • Dr. Rachel Jug (ICTMG Trainee Member) presenting the ICTMG guideline and appraised the guideline using AGREE II tool

  • Experts presenting hemoglobinopathy transfusion management strategies in their regions:

    • Dr. Arwa Al-Riyami (ICTMG Junior Member) - Perspective from the Middle East

    • Dr. Magdalene Nwokocha - Perspective from Jamaica and the Caribbean

    • Dr. Shirley Owusu-Ofori - Perspective from Africa

International reach

The ICTMG guideline on red cell matching strategies are helping to standardize transfusion practices and optimize outcomes for patients with sickle cell disease and thalassemia syndromes. Check out how the guideline is being used or adapted in different countries.

American Society of Hematology

In July 2019, the American Society of Hematology (ASH) affirmed that ICTMG’s guidelines have value for hematologists. Read the ASH statement here:


British Society for Haematology

In January 2020, the Transfusion Task Force of the British Society for Haematology (BSH) Guidelines Committee published a position paper on the applicability of ICTMG’s recommendations for transfusion practice in the U.K. For more, visit

National Advisory Committee on Blood and Blood Products (Canada)

In September 2020, the National Advisory Committee (NAC) on Blood and Blood Products (Canada) endorsed the ICTMG guidance on RBC Specifications for Patients with Hemoglobinopathies (Compernolle (2018)). Read the NAC statement here.

ICTMG logo
Canadian Blood Service logo

With funding provided by:

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