Some clinical consequences of red cell incompatibility: the Bradshaw lecture 1978

Most deaths from red cell incompatibility are due either to the transfusion of ABO-incompatibile red cell or to Rh-haemolytic disease of the newborn; almost all the deaths are preventible. It seems that approximately 1 in 5,000 recipients receive ABO-incompatible blood, a figure which implies that donor and/or recipient may be mis-identified in as many as 1 in 1,5000 transfusions. Another serious consequence of mis-identification is the transfusion of Rh-positive blood to an Rh-negative female who has no children and is not past the age of childbearing. The need for rigorous checking procedures to ensure that patients are transfused with the 'right' blood cannot be stated too often. Some deaths from Rh-haemolytic disease of the newborn are due to the fact that the mother has not received suppressive therapy after a previous pregnancy. Wider recognition of the great importance of administering anti-D to women who might otherwise become immunised would save many lives.