Barty R L, Pai M, Liu Y, Arnold D M, Cook R J, Zeller M P, Heddle N M
Department of Medicine and McMaster Centre for Transfusion Research, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada.
Vox Sang. 2017 May;112(4):336-342. doi: 10.1111/vox.12492. Epub 2017 Mar 20.
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.
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 Extracted data included product type, ABO and Rh, final disposition (transfused, wasted, outdated), and demographic and clinical data on all patients admitted to hospital.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.
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.
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.
由于库存不足以及ABO血型不匹配的受血者使用O型血，O型血一直反复出现短缺情况。我们进行了一项为期12年的回顾性研究，以确定不同ABO血型受血者对O Rh阳性和Rh阴性红细胞（RBC）的使用情况。还评估了向ABO血型不匹配的受血者输注O型血的原因。
纳入2002年4月至2014年3月期间在三家学术医院输注的所有O Rh阳性和Rh阴性RBC的使用数据。数据从输血利用监测与追踪登记处提取，该登记处是一个全面的数据库，包含医院接收的所有血液制品的库存信息。提取的数据包括产品类型、ABO和Rh血型、最终处置情况（输注、废弃、过期）以及所有住院患者的人口统计学和临床数据。使用SAS 9.3进行描述性统计。
共进行了314968次RBC输血：其中151645次（48.1%）为O型血，其中138136个（91.1%）RBC单位输注给了O型血个体。ABO血型不匹配的受血者接受了13509个O型RBC（8.9%）。按财年计算，输注给ABO血型不匹配受血者的O型RBC百分比从7.8%到11.1%不等，2011年至2013年呈稳步上升趋势。原因包括：创伤、过期、门诊使用和短缺。
向非O型个体输注O型RBC的做法一直在增加。可以针对性地制定特定的医院和血液供应商政策来改变这种做法，从而实现O型红细胞供应更具可持续性。
