Use of O RhD‐negative red blood cells: A nationwide, prospective audit

Abstract

Background and Objectives Despite declining transfusion rates, overuse of O RhD‐negative red blood cells (RBCs) risks the secure supply of this limited resource. A nationwide prospective audit was performed in Finland to understand the clinical use and inventory management of O RhD‐negative units. Our aim was to identify areas where policy changes could help alleviate the shortage of O RhD‐negative RBCs. Materials and Methods The use of every O RhD‐negative unit in Finland during a period of 1 month was reviewed. For each issued unit (n = 1105), unit age, urgency of transfusion, hospital and patient demographics, and specific reasons for issuing O RhD‐negative units were recorded. Results Almost half of the O RhD‐negative units (n = 529, 47.9%) were issued to non‐O RhD‐negative patients. Only 22.3% (n = 118) were issued for females under the age of 50. Of the units for ABO‐nonidentical transfusion, one‐third (32.5%, n = 172) were issued for emergency transfusion, two‐thirds (67.5%, n = 357) for non‐urgent transfusions. The most common reason for issuing an O RhD‐negative unit was inventory management (n = 172, 48.2% of units issued for non‐urgent transfusion). Most of these units were issued close to the unit expiry date. Conclusion This nationwide audit revealed that a significant proportion of O RhD‐negative RBCs are used inappropriately. Clinicians should be educated on the appropriate use of O RhD‐negative RBCs, and blood banks should develop strategies for inventory management to avoid issuing O RhD‐negative units purely to prevent outdating.

Blood lactate after pre‐hospital blood transfusion for major trauma by helicopter emergency medical services

“…Several scoring tools have been proposed, but none provide optimal diagnostic performance for routine clinical use [3][4][5][6][7][8]. Current practice, therefore, results in a substantial proportion of patients receiving potentially avoidable transfusions [9][10][11][12].…”

Low titer group O whole blood and risk of RhD alloimmunization: Rationale for use in Finland

“…Shortages of O RhD negative RBCs are common, [7][8][9] and to improve the availability of O RhD negative RBCs for group-specific and emergency transfusions in the hospital, LTOWB for prehospital use is usually RhD positive. 10 The downside to transfusing exclusively RhD positive LTOWB is the potential RhD alloimmunization in RhD negative recipients.…”