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Updated: Feb 8, 2026

Measuring Deformability and Red Cell Heterogeneity in Blood by Ektacytometry
Published on: January 12, 2018
Unmatched Type O RhD+ Red Blood Cells in Multiple Injured Patients
Sabine Flommersfeld1, Carsten Mand2, Christian A Kühne3
1Center for Transfusion Medicine and Hemotherapy, University Hospital Gießen and Marburg, Marburg Campus, Marburg, Germany.
Background:
Immediate supply of red blood cell (RBC) concentrates is crucial in the initial treatment of exsanguinating patients in the emergency room. General shortage of RhD- RBCs has led to protocols in which patients with unknown blood groups are initially transfused with group O, RhD+ RBCs. Limited data are available regarding the safety of such an approach.
Methods:
Transfusion protocols for all multiple injured patients from the regional polytrauma database were retrospectively analyzed over a period of 5 years. Data on side effects were retrieved from the local safety update registry. Follow-up data were obtained from patients with identified RhD-incompatible transfusions.
Results:
In total, 823 patients were registered as multiple injured in the database. An immediate transfusion of 259 units (mean number of units 4, range 1-6) group O, RhD+ RBCs was initiated in 62 of them. 14 of these patients were RhD- and received 60 units of RhD-incompatible RBCs in the emergency room. In the later course RhD- patients received additional 185 incompatible transfusions (13; 1-31). The overall seroconversion rate was 50%. No adverse outcome due to incompatible transfusion was observed.
Conclusions:
Initial supply with group O, RhD+ RBCs in multiple injured patients appears to be safe. Significant numbers of RhD- units can be saved for use in other patients.
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