Group O RBCs: where is universal donor blood being used.
BACKGROUND
There have been recurrent shortages of group O blood due to insufficient inventory and use of group O blood in ABO non-identical recipients. We performed a 12-year retrospective study to determine utilization of group O Rh-positive and Rh-negative red blood cells (RBCs) by recipient ABO group. Reasons for transfusing group O blood to ABO non-identical recipients were also assessed.


METHODS
Utilization data from all group O Rh-positive and Rh-negative RBCs transfused at three academic hospitals between April 2002 and March 2014 were included. Data were extracted from Transfusion Registry for Utilization Surveillance and Tracking, a comprehensive database with inventory information on all blood products received at the hospitals. Extracted data included product type, ABO and Rh, final disposition (transfused, wasted, outdated), and demographic and clinical data on all patients admitted to hospital. Descriptive statistics were performed using sas 9.3.


RESULTS
There were 314 968 RBC transfusions: 151 645 (48·1%) were group O, of which 138 136 (91·1%) RBC units were transfused to group O individuals. ABO non-identical recipients received 13 509 group O RBCs (8·9%). The percentage of group O RBCs transfused to ABO non-identical recipients by fiscal year varied from 7·8% to 11·1% with a steady increase from 2011 to 2013. Reasons for this included: trauma, outdating, outpatient usage and shortages.


CONCLUSIONS
The practice of transfusing O RBCs to non-O individuals has been increasing. Specific hospital and blood supplier policies could be targeted to change practice, leading to a more sustainable group O red blood cell supply.
Department of Medicine and McMaster Centre for Transfusion Research, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
R L
RL
Barty
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada.
M
M
Pai
Department of Medicine and McMaster Centre for Transfusion Research, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
Y
Y
Liu
Department of Medicine and McMaster Centre for Transfusion Research, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.|Centre for Innovation, Canadian Blood Services, Hamilton, ON, Canada.
D M
DM
Arnold
Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON, Canada.
R J
RJ
Cook
Department of Medicine and McMaster Centre for Transfusion Research, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.|Centre for Innovation, Canadian Blood Services, Hamilton, ON, Canada.
M P
MP
Zeller
Department of Medicine and McMaster Centre for Transfusion Research, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.|Centre for Innovation, Canadian Blood Services, Hamilton, ON, Canada.
N M
NM
Heddle
D000017:ABO Blood-Group System; D000293:Adolescent; D000328:Adult; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012204:Rh-Hr Blood-Group System; D055815:Young Adult
D000017:ABO Blood-Group System; D012204:Rh-Hr Blood-Group System
blood group; quality management; red cell components; transfusion medicine