Unmatched Type O RhD+ Red Blood Cells in Multiple Injured Patients

Area of Science:

• Emergency Medicine
• Transfusion Medicine
• Hematology

Background:

• Immediate red blood cell (RBC) transfusion is critical for exsanguinating trauma patients.
• Shortages of RhD-negative RBCs necessitate using RhD-positive RBCs for unknown blood types.
• Limited data exist on the safety of transfusing RhD-positive RBCs to RhD-negative patients.

Purpose of the Study:

• To evaluate the safety of initial transfusion with group O, RhD-positive RBCs in multiple injured patients.
• To assess adverse outcomes associated with RhD-incompatible transfusions in trauma care.

Main Methods:

• Retrospective analysis of transfusion protocols for multiple injured patients over 5 years.
• Review of local safety registries for transfusion-related side effects.
• Follow-up data collection for RhD-negative patients receiving RhD-incompatible RBCs.

Main Results:

• 62 of 823 multiple injured patients received initial group O, RhD-positive RBCs.
• 14 RhD-negative patients received 60 RhD-incompatible RBC units in the emergency room.
• No adverse outcomes were observed despite a 50% seroconversion rate in RhD-negative patients.

Conclusions:

• Initial transfusion with group O, RhD-positive RBCs appears safe for multiple injured patients.
• This transfusion strategy can conserve valuable RhD-negative RBC units.
• The findings support the use of group O, RhD-positive RBCs in emergency trauma situations.