Group O Rh(D)-negative red blood cells (RBCs) are a highly valuable resource because they possess the unique ability to be safely transfused into patients of any ABO Rh(D) blood type. As a result, inventory shortages have the potential to greatly affect patient safety, particularly in the emergency setting. Optimal use of group O RBCs can vary based on the specific patient population, clinical practice setting, and availability of testing services.
In a recent association bulletin published by AABB, Claudia S Cohn, MD, PhD, of the department of laboratory medicine and pathology at the University of Minnesota in Minneapolis, and colleagues provided expert recommendations on the optimal use of group O Rh(D)-negative RBCs in an effort to reduce overdependence on this limited resource. The development of the guidelines was chaired by Dr Cohn in collaboration with the AABB’s Clinical Transfusion Medicine Committee.
Dr Cohn told Hematology Advisor, “[The] AABB association bulletins give the latest recommendations from experts in the field [of transfusion medicine].”
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Group O RBCs should be appropriated for women of childbearing potential who are: Rh(D)-negative, thereby necessitating transfusion when type-specific blood is not available; of unknown blood type and need RBCs prior to finishing pretransfusion testing; or group O Rh(D)-negative.
In addition, the experts recommended that hospitals should closely monitor their group O inventory, particularly during times of shortage. Furthermore, they suggested that policy development is essential to ensure that patients can be switched to Rh(D)-positive RBCs to prevent depletion of the group O supply.
They also recommended that hospitals should enact protocols to accelerate sample collection to rapidly transition patients to type-specific blood at the completion of pretransfusion testing.
“Provision of group O Rh(D)-positive RBCs should be considered for air and/or ground ambulance and/or emergency department transfusions,” Dr Cohn and colleagues wrote.
