For Blood Centers

Collection facilities should collaborate with hospitals to support optimal use and enact reasonable targets for group O utilization. Inventory par levels should be established according to the particular conditions of the hospital or system using the best available evidence. Collaborative monitoring and auditing of group O use is also recommended.

“Collection facilities should provide genotype or extended phenotype information for RBC units of all blood types to encourage type-specific usage,” the authors added.

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For Specific Patient Populations

In patients of unknown ABO type with massive hemorrhaging, group O RBCs are suitably administered during initial resuscitation. In transplant populations, group O RBC use is extensive as ABO incompatibility is common in these patients. In neonatal populations, isohemagglutinins are passively received from the maternal circulation; hence, only testing neonatal ABO forward type is necessary.

“Clinically appropriate triage algorithms that assign specific decision-making responsibility and authority can be developed to control group O RBC use under both routine and shortage conditions,” the authors recommended.

Clinical Tips and Moving Forward

As the pressure to support adequate group O Rh(D)-negative inventory rises, implementation of these recommendations is essential to preventing shortages and maintaining patient safety. Both hospitals and collection facilities can collaborate to develop strategies to minimize group O RBC use. At present, 6.9% of the donor base is made up of Group O Rh(D)-negative volunteers, while 10.8% of transfusions in 2015 used Group O Rh(D)-negative RBCs.

In order to stay up to date on new advances in the field of transfusion medicine, Dr Cohn told Hematology Advisor, “[Clinicians] can sign up for emails from the journal Transfusion, which sends the titles of important new articles and table of contents when new editions are published.”

She added, “Finally, a quick scan of AABB association bulletins gives the latest recommendations from experts in the field.”


1. Michael Murphy, Debra BenAvram; AABB. Recommendations on the Use of Group O Red Blood Cells [association bulletin #19-02]. Published June 26, 2019. Accessed July 23, 2019.