title: Transfusion of D+ red blood cells to D- individuals in trauma situations.
abstract: To conserve D- red blood cells (RBCs), our facility developed a policy for transfusion of D+ units to D- patients, particularly in trauma situations. To our knowledge, this is the first study looking at D-mismatched RBC transfusion in trauma patients. We developed guidelines for the transfusion of D-mismatched RBCs. patients were followed by anti body screening and direct antiglobulin testing. Twenty-six patients were identified, and 57.7 percent of the cases were the result of trauma. Follow-up ranged from 7 to 455 days. The trauma cohort had a follow-up of 7 to 102 days. Overall, patients were transfused with 1 to 36 units of D-mismatched RBCs. Three patients produced alloanti-D, resulting in a 20 percent rate of antibody formation rate of 11.5 percent compared with 21.4 to 30.4 percent in previous studies. Approximately 58 percent of our study population was composed of trauma patients. Within that cohort, the formation of anti-D was 20 percent, similar to the rate seen in previous studies looking at primarily non-trauma populations.
authors.affiliation: MD (corresponding author), Pathology Resi-dent, University of Texas Medical School at Houston, Department of Pathology and Laboratory Medicine.
authors.forename: Amanda
authors.initials: A
authors.lastname: Tchakarov
authors.affiliation: BS, Blood Bank Supervisor, Memorial Hermann Hospital, Texas Medical Center, 6411 Fannin, Houston, TX 77030.
authors.forename: Rhonda
authors.initials: R
authors.lastname: Hobbs
authors.affiliation: MD, PhD, Assistant Professor, University of Texas Medical School at Houston, Department of Pathology and Laboratory Medicine, 6431 Fannin Street, MSB 2.262, Houston, TX 77030.
authors.forename: Yu
authors.initials: Y
authors.lastname: Bai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001787:Blood Group Incompatibility; D003298:Coombs Test; D017707:Erythrocyte Transfusion; D004912:Erythrocytes / Q000166:cytology / Q000276:immunology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007518:Isoantibodies / Q000097:blood*; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012204:Rh-Hr Blood-Group System / Q000276:immunology*; D014947:Wounds and Injuries / Q000097:blood / Q000276:immunology / Q000473:pathology / Q000628:therapy*
chemical_list: D007518:Isoantibodies; D012204:Rh-Hr Blood-Group System; C026410:Rho(D) antigen