Utilisation patterns of group O red blood cell transfusion by ABO and D non-identical recipients in large academic...

Several studies have raised concerns that transfusion of O red blood cells (RBCs) to ABO and D non-identical recipients can intensify group O inventory shortages. The aim of this study was to retrospectively analyse particular clinical indications and polices responsible for O RBCs use by ABO and D non-identical recipients, as well as to assess the impact of this practice on the overall utilisation of O RBCs.

Data of all transfused RBCs from 2014 to 2018 were extracted from the comprehensive database of transfusion service. Extracted variables included date of transfusion, ABO and D group of the transfused RBCs and recipients, recipient's demographic, and specific characteristics regarding transfusion requirements.

Over a 5-year period, 124,220 RBCs were transfused: 38,962 (31.4%) group O D+ and 9109 (7.3%) group O D-. ABO and D non-identical recipient received 4842 (10.1%) of all administered O RBCs: 2880 (7.4%) of all transfused O D+ and 1962 (21.5%) of all transfused O D- RBCs. The common indications for this practice were: ABO and D mismatched hematopoietic stem cell transplantation (HSCT) (52.5%), infants under the age of 4 months (18.6%), shortage of ABO identical RBCs (9.0%), phenotype-matched RBCs (8,1%), and urgent transfusion (7.2%).

A significant proportion of O RBCs was transfused to ABO and D non-identical recipients, mainly due to transfusion of ABO and D mismatched HSCT recipients. However, the proportion of all transfused RBCs O D+ and especially O D- remained relatively low.