Ideally patients should receive blood components from identical and compatible donors. However, in certain emergency situations or when products supply is low, a patient may need to receive a product from a donor with a different ABO type. In addition, it may be rarely necessary to transfuse an Rh-positive product to an Rh-negative recipient. The development of red blood cell substitutes eventually may make such situations obsolete.
|
Product |
Requirements |
|
whole blood |
product must be identical to the recipient's ABO type |
|
packed red blood cells in transport medium |
red cells must be compatible with the recipient's plasma (see table below) |
|
fresh frozen plasma (FFP) |
must be compatible with the recipient's red blood cells |
|
platelets |
any ABO group can be used, but components compatible with the recipient's red blood cells preferable |
Prior to the use of additives to suspend red cell products, more care had to be exercised, since more donor plasma was present in the product, which could result in donor-to-recipient transfusion reactions, especially if large volumes of donor products were transfused or if the donor had a high titered antibody present.
Selection of RBC Donor Unit Based on ABO and Rh Type
|
|
Donor Unit |
|
Patient Type |
O- |
O+ |
B- |
B+ |
A- |
A+ |
AB- |
AB+ |
|
AB+ |
x |
x |
x |
x |
x |
x |
x |
x |
|
AB- |
x |
|
x |
|
x |
|
x |
|
|
A+ |
x |
x |
|
|
x |
x |
|
|
|
A- |
x |
|
|
|
x |
|
|
|
|
B+ |
x |
x |
x |
x |
|
|
|
|
|
B- |
x |
|
x |
|
|
|
|
|
|
O+ |
x |
x |
|
|
|
|
|
|
|
O- |
x |
|
|
|
|
|
|
|
(from a Quick Reference Card distributed by Community Blood Center, Dayton, Ohio)
Whenever possible, Rh-negative patients should receive Rh-negative products. However, in emergencies it may be necessary to transfuse an Rh-positive product to an Rh-negative patient, when the risk of severe anemia is greater than the risk of possible alloimmunization or transfusion reaction. Some rules to be followed in this situation:
(1) Young girls or women of childbearing age should be given any remaining Rh-negative products in preference to other groups (such as men or post-menopausal women).
(2) Before an Rh-positive product is given to an Rh-negative testing, antibody screening and compatibility testing should be completed to exclude the possibility of a pre-existing alloantibody.
(3) Sometimes an Rh-negative patient who has received an Rh-positive product may be given sufficient Rh Immune Globulin to prevent alloimmunization, but the cost of this can be extremely high unless the volume of product is very low.
Specialty: Clinical Laboratory
