Liker M, Lukać I K, Burnać I L, Bojanić I, Raos M, Ćepulić B G
Clinical Department of Transfusion Medicine and Transplantation biology, University Hospital Centre of Zagreb, Kišpatićeva 12, 10 000 Zagreb, Croatia.
General Hospital of Gospić, Gospić, Croatia.
Transfus Clin Biol. 2021 May;28(2):186-190. doi: 10.1016/j.tracli.2021.01.005. Epub 2021 Jan 28.
Several studies have raised concerns that transfusion of O red blood cells (RBCs) to ABO and D non-identical recipients can intensify group O inventory shortages. The aim of this study was to retrospectively analyse particular clinical indications and polices responsible for O RBCs use by ABO and D non-identical recipients, as well as to assess the impact of this practice on the overall utilisation of O RBCs.
Data of all transfused RBCs from 2014 to 2018 were extracted from the comprehensive database of transfusion service. Extracted variables included date of transfusion, ABO and D group of the transfused RBCs and recipients, recipient's demographic, and specific characteristics regarding transfusion requirements.
Over a 5-year period, 124,220 RBCs were transfused: 38,962 (31.4%) group O D+ and 9109 (7.3%) group O D-. ABO and D non-identical recipient received 4842 (10.1%) of all administered O RBCs: 2880 (7.4%) of all transfused O D+ and 1962 (21.5%) of all transfused O D- RBCs. The common indications for this practice were: ABO and D mismatched hematopoietic stem cell transplantation (HSCT) (52.5%), infants under the age of 4 months (18.6%), shortage of ABO identical RBCs (9.0%), phenotype-matched RBCs (8,1%), and urgent transfusion (7.2%).
A significant proportion of O RBCs was transfused to ABO and D non-identical recipients, mainly due to transfusion of ABO and D mismatched HSCT recipients. However, the proportion of all transfused RBCs O D+ and especially O D- remained relatively low.
多项研究引发了人们对向ABO和D血型不匹配的受血者输注O型红细胞（RBC）会加剧O型血库存短缺的担忧。本研究的目的是回顾性分析ABO和D血型不匹配的受血者使用O型RBC的特定临床指征和政策，并评估这种做法对O型RBC总体使用情况的影响。
从输血服务综合数据库中提取2014年至2018年所有输注RBC的数据。提取的变量包括输血日期、输注RBC和受血者的ABO和D血型、受血者的人口统计学信息以及输血需求的具体特征。
在5年期间，共输注了124,220个RBC：38,962个（31.4%）O型D阳性和9109个（7.3%）O型D阴性。ABO和D血型不匹配的受血者接受了所有输注的O型RBC中的4842个（10.1%）：所有输注的O型D阳性中的2880个（7.4%）和所有输注的O型D阴性RBC中的1962个（21.5%）。这种做法的常见指征为：ABO和D血型不匹配的造血干细胞移植（HSCT）（52.5%）、4个月以下婴儿（18.6%）、ABO血型相同的RBC短缺（9.0%）、表型匹配的RBC（8.1%）以及紧急输血（7.2%）。
相当一部分O型RBC被输注给了ABO和D血型不匹配的受血者，主要原因是ABO和D血型不匹配的HSCT受血者的输血。然而，所有输注的RBC中O型D阳性尤其是O型D阴性的比例仍然相对较低。
