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Parent perceptions of emergent blood transfusion in children
Katrina M Morgan1, Rachel Lobo2, Kyle Annen3,4
1Department of General Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Insights
Most parents accept RhD-positive blood transfusions for RhD-negative female children in emergencies. Parental willingness increases with the transfusion
Area of Science:
- Pediatric Hematology
- Transfusion Medicine
- Medical Ethics
Background:
- Chronic shortages of RhD-negative blood products necessitate exploring alternatives.
- Renewed interest in using RhD-positive blood for emergency transfusions in RhD-negative individuals.
Purpose of the Study:
- To assess parental perceptions and acceptance of emergency RhD-positive blood transfusions for RhD-negative female children.
- To understand parental willingness to accept RhD-positive blood in life-threatening situations.
Main Methods:
- A survey was conducted among parents/guardians at four pediatric hospitals.
- Participants were asked about their tolerance for transfusing RhD-positive blood to RhD-negative female children aged ≤17 years.
- Demographic data and knowledge of children's blood types were collected.
Main Results:
- Over 80% of parents accepted RhD-positive blood for RhD-negative female children in life-threatening situations, with a 0-6% risk to future fetuses.
- Parental willingness significantly increased with the perceived survival benefit of the transfusion.
- Many parents were unaware of their children's RhD blood type.
Conclusions:
- A majority of parents are willing to accept RhD-positive blood for RhD-negative female children during emergencies.
- Further dialogue and evidence-based guidelines are needed for transfusing RhD-positive blood products in emergency settings, especially for RhD-unknown females.
Background:
RhD-negative blood products are in chronic short supply leading to renewed interest in utilizing RhD-positive blood products for emergency transfusions. This study assessed parental perceptions of emergency RhD-positive blood use in children.
Methods:
A survey of parents/guardians was conducted on their tolerance of transfusing RhD-positive blood to RhD-negative female children ≤17 years old at four level 1 pediatric hospitals.
Results:
In total, 621 parents/guardians were approached of whom 378/621 (61%) completed the survey in its entirety and were included in the analysis. Respondents were mostly females [295/378 (78%)], White [242/378 (64%)], had some college education [217/378 (57%)] and less than $60,000 annual income [193/378 (51%)]. Respondents had a total of 547 female children. Most children's ABO [320/547 (59%)] and RhD type [348/547 (64%)] were not known by their parents; of children with known RhD type, 58/186 (31%) were RhD-negative. When the risk of harm to a future fetus was given as 0-6%, more than 80% of respondents indicated that they were likely to accept RhD-positive blood transfusions on behalf of RhD-negative female children in a life-threatening situation. The rate of willingness to accept emergent RhD-incompatible blood transfusions significantly increased as the potential survival benefit of the transfusion increased.
Conclusion:
Most parents were willing to accept RhD-positive blood products on behalf of RhD-negative female children in an emergency situation. Further discussions and evidence-based guidelines on transfusing RhD-positive blood products to RhD-unknown females in emergency settings are needed.
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