Prospective evaluation of a transfusion policy of D+ red blood cells into D- patients

Transfusion
Jose R Gonzalez-PorrasMercedes Corral

Abstract

Although D- patients should receive red blood cells (RBCs) from D- donors, the scarcity of D- blood components in certain situations makes the transfusion of D+ RBCs unavoidable. Therefore it is recommended that guidelines be developed in order to standardize transfusion policy in these scenarios. We have prospectively evaluated a policy for the use of D+ RBCs in 905 D- patients. The amount of D- RBCs saved as well as the incidence of hemolytic reactions and anti-D alloimmunization were assessed. 554 patients received D- RBCs while 351 received a total of 1032 D+ RBCs, all of them within our criteria for the acceptable use of D+ RBCs. This strategy allowed us to save 25.6 percent of D- RBCs (1032 out of 4024 RBCs requested). No hemolytic reactions were reported. The incidence of alloimmunization was 21.4 percent. Most patients who developed anti-D did so within the first 2 or 4 RBCs transfused (64% after the first 2 RBCs transfused and 88% after the first 4). In multivariate analysis the age of less than 77 years was the only predictor for alloimmuization (HR = 2.48 [95% CI = 1.21-3.81]; p = 0.014). The use of D+ RBCs in selected D- patients does not induce adverse reactions and allows the saving of a significant number of D- R...Continue Reading

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Citations

Dec 10, 2013·Bone Marrow Transplantation·G S BoothB N Savani
Dec 3, 2014·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Awatef SassiSaloua Jemni Yacoub
Oct 30, 2012·Transfusion clinique et biologique : journal de la Société française de transfusion sanguine·B-N PhamP Rouger
Jan 17, 2012·Transfusion Medicine Reviews·Esther P VerduinHenk Schonewille
Nov 6, 2010·Transfusion clinique et biologique : journal de la Société française de transfusion sanguine·J-Y Py
Jul 29, 2008·Transfusion·Regina M LegerGeorge Garratty
Jan 15, 2009·Transfusion·Joan Cid, Laia Ramiro
Feb 26, 2013·British Journal of Haematology·Geoff Daniels
Dec 3, 2014·Transfusion·Erin Meyer, Lynne Uhl
Oct 7, 2014·British Journal of Haematology·Joan CidUNKNOWN Biomedical Excellence for Safer Transfusion collaborative
Sep 29, 2015·Current Opinion in Hematology·Joan CidMiguel Lozano
Dec 19, 2017·Anesthesiology·Mark H YazerUNKNOWN AABB (formerly known as the American Association of Blood Banks)/Trauma, Hemostasis, Oxygenation Resuscitation Network (THOR
Jan 15, 2018·Transfusion·Mark H YazerDarrell J Triulzi
Jun 28, 2018·Transfusion·Robert A DeSimone, Bruce S Sachais
Feb 27, 2018·Transfusion·Nancy M DunbarUNKNOWN OPTIMUS Study Investigators on behalf of the Biomedical Excellence for Safer Transfusion (BEST) Collaborative
Jun 6, 2020·Transfusion·Vishesh G ChhibberSherry Shariatmadar
Sep 25, 2019·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Ryan NewberryJulian Mapp
Jun 22, 2018·Transfusion Medicine and Hemotherapy : Offizielles Organ Der Deutschen Gesellschaft Fur̈ Transfusionsmedizin Und Immunham̈atologie·Sabine FlommersfeldUlrich J Sachs
Dec 4, 2019·Anesthesiology·Mark H YazerUNKNOWN Biomedical Excellence for Safer Transfusion Collaborative*
Sep 6, 2019·CMAJ Open·Jeannie L CallumKaterina Pavenski

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