Improved allocation strategies for red cell units of blood group O and RhD-negative revealed by current suboptimal...

Demand for O RhD-negative red cells continues to rise, while overall red cell transfusions have decreased, compounding inventory management challenges. We analyzed O RhD-negative red cell utilization in a large publicly available database.

Data from 378,855 red cell transfusions were evaluated using the Recipient Epidemiology and Donor Evaluation Study-III (REDS-III). Utilization patterns, recipient demographics, and their correlation with the age of red cell units at transfusion were examined.

The majority of O RhD-negative units were transfused to patients with blood groups other than O RhD-negative (54.5%). A larger percentage of O RhD-negative red cells were transfused after 35 days of collection (41%), compared to other blood groups (18.7%). Patients over 50 years, males, non-O RhD-negative and RhD-positive individuals had higher odds of receiving units stored more than 35 days. Patients with higher hemoglobin concentrations were more likely to receive older blood units.

The analysis identified opportunities to improve the allocation of O RhD-negative red cell units, highlighting current inventory practices as suboptimal. The findings call for refined allocation strategies to improve the utilization of this limited resource. The implementation of real-time management approaches may balance the retention of such red cell units with the needs of patients who benefit from the use of RhD-negative blood.