**6. Conclusions**

Alloimmunization remains a major risk for transfusion-dependent patients for whom transfusion is critical for survival. The transfusion management of patients who have already been alloimmunized is still a challenge when rare blood types are involved, but for new patients there is a hope that genotyping will help minimize exposure, except for those very rare alleles which are hard to find. One approach to overcome this limitation is to create a database for rare and very rare RBC alleles where donor selection is based on genotyping and the donor pool is constantly enhanced and updated. The use of RBC genotyping for both rare donor selection and patient care is path forward in transfusion therapy and transfusion safety. The development of new assays and high throughput platforms will enable mass-scale genotyping at lower cost and rapid pace to select rare and very rare donors. The development and availability of reference reagents will allow better quality control in assay development and evaluation of performance and proficiency of testing by specialized laboratories making patient care easier and safer to provide.
