Finnish Red Cross Blood Service, Vantaa, Finland.
Emergency Medical Service and Emergency Department, Päijät-Häme wellbeing services county, Lahti, Finland.
Transfusion. 2024 May;64 Suppl 2:S119-S125. doi: 10.1111/trf.17700. Epub 2024 Jan 19.
Prehospital low-titer group O whole blood (LTOWB) used for patients with life-threatening hemorrhage is often RhD positive. The most important complication following RhD alloimmunization is hemolytic disease of the fetus and newborn (HDFN). Preceding clinical use of RhD positive LTOWB, we estimated the risk of HDFN due to LTOWB prehospital transfusion in the Finnish population.
We collected data on prehospital transfusions in Tampere and Helsinki University Hospital areas. Using the mean of reported alloimmunization rates in trauma studies (24%) and a higher reported rate representing trauma patients of 13-50 years old (42.7%), we estimated the risk of HDFN and extrapolated it to the whole of Finland.
We estimated that in Finland, with the current prehospital transfusion rate we would see 1-3 cases of severe HDFN due to prehospital LTOWB transfusions every 10 years, and fetal death due to HDFN caused by LTOWB transfusion less than once in 100 years.
The estimated risk of serious HDFN due to prehospital LTOWB transfusion in the Finnish population is similar to previous estimates. As Finland routinely screens expectant mothers for red blood cell antibodies and as the contemporary treatment of HDFN is very effective, we support the prehospital use of RhD positive LTOWB in all patient groups.
用于治疗有生命危险出血的患者的院前低滴度 O 型全血（LTOWB）通常为 RhD 阳性。RhD 同种免疫后最重要的并发症是胎儿和新生儿溶血病（HDFN）。在院前使用 RhD 阳性 LTOWB 之前，我们估计了在芬兰人群中由于院前 LTOWB 输血导致 HDFN 的风险。
我们收集了坦佩雷和赫尔辛基大学医院地区的院前输血数据。使用创伤研究中报告的同种免疫率平均值（24%）和代表 13-50 岁创伤患者的较高报告率（42.7%），我们估计了 HDFN 的风险，并将其外推到整个芬兰。
我们估计，按照目前的院前输血率，每 10 年我们将看到 1-3 例由于院前 LTOWB 输血导致的严重 HDFN，并且由于 LTOWB 输血导致的 HDFN 胎儿死亡不到 100 年一次。
芬兰人群院前 LTOWB 输血导致严重 HDFN 的估计风险与先前的估计相似。由于芬兰常规筛查孕妇的红细胞抗体，并且当代 HDFN 的治疗非常有效，我们支持在所有患者群体中院前使用 RhD 阳性 LTOWB。
