A national review of the clinical use of group O D– red blood cell units

Hirani, Rena; Wong, Jenny K. Y.; Diaz, Perfecto; Mondy, Phillip; Hogan, Chris; Dennington, Peta M.; Pink, Joanne; Irving, David O.

doi:10.1111/trf.14012

Cited by 26 publications

(40 citation statements)

References 9 publications

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“…This result was significant as 24.5% of all O negative PRBC units are transfused after 35–42 days of storage in Australia. 34 These results align with the findings of in vitro studies and support the shortening of PRBC shelf life to 35 days, which has already occurred in some jurisdictions (The Netherlands, UK, Germany, China). Shortening PRBC shelf life should be approached with caution due to its implications for blood bank management, product wastage and PRBC access in remote locations.…”

Section: Discussionsupporting

confidence: 86%

Transfusion of packed red blood cells at the end of shelf life is associated with increased risk of mortality – a pooled patient data analysis of 16 observational trials

David

Middelburg

et al. 2018

Haematologica

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Observational studies address packed red blood cell effects at the end of shelf life and have larger sample sizes compared to randomized control trials. Meta-analyses combining data from observational studies have been complicated by differences in aggregate transfused packed red blood cell age and outcome reporting. This study abrogated these issues by taking a pooled patient data approach. Observational studies reporting packed red blood cell age and clinical outcomes were identified and patient-level data sets were sought from investigators. Odds ratios and 95% confidence intervals for binary outcomes were calculated for each study, with mean packed red blood cell age or maximum packed red blood cell age acting as independent variables. The relationship between mean packed red blood cell age and hospital length of stay for each paper was analyzed using zero-inflated Poisson regression. Random effects models combined paper-level effect estimates. Extremes analyses were completed by comparing patients transfused with mean packed red blood cell aged less than ten days to those transfused with mean packed red blood cell aged at least 30 days. sixteen datasets were available for pooled patient data analysis. Mean packed red blood cell age of at least 30 days was associated with an increased risk of in-hospital mortality compared to mean packed red blood cell of less than ten days (odds ratio: 3.25, 95% confidence interval: 1.27–8.29). Packed red blood cell age was not correlated to increased risks of nosocomial infection or prolonged length of hospital stay.

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Section: Discussionsupporting

confidence: 86%

Transfusion of packed red blood cells at the end of shelf life is associated with increased risk of mortality – a pooled patient data analysis of 16 observational trials

David

Middelburg

et al. 2018

Haematologica

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“…Therefore, in order to understand the absolute requirements for this product in the Australian context, a national survey was conducted to investigate how often group O D− RBC units are used in emergency situations, for neonatal transfusions and obstetric purposes, and for providing phenotypically matched units. The aggregated national data on the findings from this study have recently been published .…”

Section: Introductionsupporting

confidence: 71%

Region specific analysis for the use of ‘universal’ donor group O D− red blood cell units within Australia

Hirani

Wong

Mondy

et al. 2018

ISBT Science Series

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Objectives In Australia, the demand for group O D− red blood cell (RBC) units is proportionally increasing in contrast with an overall reduction in RBC demand. A survey was conducted to understand the use of group O D− RBC units. Aggregated national data from this study have been reported. However, Australia has large geographical and jurisdictional differences in blood product funding arrangements, transfusion and inventory management practices. This region specific analysis was conducted to understand these differences in the use of group O D− RBC units. Design The fate of each O D− RBC unit issued during a 5‐week period (n = 9733) was analysed including urgency of transfusion, product age, patient demographics or reason for discard. The data were divided to represent five regions representing 1‐2 states and/or territories across Australia. Results Regions 1 and 5 had the lowest number of O D− RBC units issued per 1000 population. Region 4 had the lowest percentage of discard (3·8%) compared with the national average of 7·9%. Region 4 also had the lowest percentage (44·0%) of O D− RBC units transfused into nongroup O D‐ recipients compared with the national average of 52·2%. Conclusions The differences in usage of group O D− RBC units among regions were not statistically significant. However, possible region specific practices, such as the presence of a well‐developed blood rotation programme, could impact O D− RBC demand. Shared learning across all regions could assist in ameliorating the increasing national O D− RBC demand in Australia.

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“…As patient blood management becomes more widespread, there has been an international decline in the demand for RBC products . Hirani et al reported that there had been a 21% reduction in demand between 2012 and 2015 in Australia. In contrast, the demand for the “universal” blood group O is, in fact, proportionally increasing .…”

Section: Discussionmentioning

confidence: 99%

Distribution of ABO/Rh blood groups and their association with hepatitis B virus infection in 3.8 million Chinese adults: A population‐based cross‐sectional study

Liu

Zhang

Liu

et al. 2018

Journal of Viral Hepatitis

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ABO and Rh blood groups play a vital role in blood transfusion safety and clinical practice and are thought to be linked with disease susceptibility. The results from previous studies that focused on the association between blood groups and HBV infection remain controversial. China has the world's largest burden of HBV infection. We assessed the distribution of ABO/Rh blood groups in Chinese adults and examined the association between these groups and HBV infection. We did a nationwide cross-sectional study using data from a physical check-up programme from 31 provinces examined between 2010 and 2012. ELISA was used to test for HBsAg in serologic samples. Multivariable logistic regression was used to estimate aOR of the association between ABO and Rh blood groups and HBV infection. Among 3 827 125 participants, the proportion of participants with blood group A was highest (30.54%), followed by O (30.37%), B (29.42%) and AB (9.66%). A total of 38 907 (1.02%) were Rh-D negative. The prevalence of HBsAg in blood groups O, A, B and AB were 6.34%, 5.55%, 5.18% and 5.06%, respectively. HBsAg prevalence was 5.65% in Rh-D-positive and 3.96% in Rh-D-negative participants. After controlling for other potential risk factors, multivariate models showed that participants with blood group O (adjusted OR = 1.22, 95% CI: 1.20-1.25) were at higher risk of HBV infection compared with group AB. Rh-D-positive participants (adjusted OR = 1.44, 95% CI: 1.37-1.52) were at higher risk of HBV infection than Rh-D-negative participants. The associations between ABO/Rh blood groups and HBV infection were similar in subgroup analysis. The proportions of O, A, B and AB blood groups were approximately 3:3:3:1, and nearly 1 in 100 people was Rh-D negative among Chinese adults. Blood group O and Rh-D positivity were both associated with increased HBV infection. The risk of HBV infection and blood safety should be taken into consideration in clinical practice, especially when transfusing those with blood group O. Awareness and prevention of HBV infection is of particular importance for individuals with blood group O.

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A national review of the clinical use of group O D– red blood cell units

Cited by 26 publications

References 9 publications

Transfusion of packed red blood cells at the end of shelf life is associated with increased risk of mortality – a pooled patient data analysis of 16 observational trials

Transfusion of packed red blood cells at the end of shelf life is associated with increased risk of mortality – a pooled patient data analysis of 16 observational trials

Region specific analysis for the use of ‘universal’ donor group O D− red blood cell units within Australia

Distribution of ABO/Rh blood groups and their association with hepatitis B virus infection in 3.8 million Chinese adults: A population‐based cross‐sectional study

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