Continuing education episode! Alloimmunization after red blood cell (RBC) transfusion is a huge challenge in the treatment of sickle cell disease (SCD). Even when donors and patients are matched using traditional serologic strategies, and even that matching includes blood from minority donors, anti-Rh antibodies in patients with sickle cell disease are formed way often than we would like or expect. Further, Dr. Stella Chou has shown that nearly a third of patients with those new antibodies actually have hemolytic transfusion reactions! It's a huge problem. In this interview, Stella Chou, a pediatric hematologist from Philadelphia, shares data she published in 2018 showing that the problem comes in part from widespread genetic RH variations in both African-American blood donors and patients with sickle cell disease. She models a future direction that may help us finally solve this problem once and for all: Genotype matching of donors and patients!