Background/Case Studies: Group O-negative red blood cells (RBCs) are a precious resource due to their scarcity in the general population (~7%). Their effective utilization by transfusion services and blood banks is critical. Although there are instances when group O-negative RBCs must be transfused to non-group O-negative patients, such as in trauma situations, there are opportunities to optimize their use whenever possible. This study aims to demonstrate how retrospective analysis of out-of-group O-negative RBC transfusions can be utilized to identify policy changes that may reduce inappropriate usage.
Study
Design/Methods: In collaboration with our blood supplier, we established an automated reporting system to track instances of O-negative RBC transfusions to non-O-negative patients. Each instance was investigated to determine the reason for allocation and categorized into several groups such as emergency use, antigen negative special need, etc. Monthly meetings between the transfusion service and blood supplier were held to discuss findings and implement necessary adjustments to inventory and workflows
Results/Findings: In the 12 months prior to the study (September 2022 to August 2023), 1,878 O-negative RBCs were transfused to non-O-negative patients. After implementing the initiative (September 2023 to August 2024), this number decreased to 1,390, reflecting a 25.9% reduction in out-of-group O-negative RBC usage. Key changes included revising internal policies to allow non-group O RBC units for pediatric aliquots and increasing the inventory of group O-positive and A-positive RBCs tagged with the Hemoglobin S-negative (HbS Neg) designation. Increased awareness among transfusion service staff further contributed to the careful selection of appropriate blood products. Conclusions: This study demonstrates the impact of meticulous monitoring of out-of-group O-negative RBC transfusion data. Small adjustments can lead to significant and lasting improvements in blood resource management. Strong collaboration between transfusion services and blood suppliers is essential for optimizing the use of O-negative RBCs. Continued monitoring will further enhance the efficiency of out-of-group RBC utilization, ensuring that this vital resource is preserved for critical needs.
