(P-TS-56) Group O Red Blood Cell Use in a Multi-Center Health Care System

Data was retrieved from Haemonetics SafeTraceTx transfusion service laboratory information system. Custom transfused reports were run for 16 medical centers for January and February 2024, statistics were tallied on the total number of red blood cell units (RBC) transfused (4569) along with blood group of donor unit and patient blood group. An analysis was done of situations where donor unit blood group was O and differed from the patient blood group which included reviewing unit records for emergency release, issuance with outdate of three days or less, and patient history for alloimmunization and special requirements. An inventory count was performed of sixteen transfusion services on two separate days and averages and percentages of the respective blood types were taken.

Results/Findings:

For the region analyzed, ONRBC inventory was 19.6% of total red blood cell inventory. Patient O-neg was 5.7% compared to ONRBC being transfused at a 9.6% rate of total red cells transfused. ONRBC were transfused to group O-neg patients at a 59.1% rate. Group O blood was transfused to group O patients at a 90.5% rate (Table 1).

Of the 180 ONRBC transfused to non-O-neg patients, primary causes were emergency release (46 units), inventory depletion (29), short date (28), irradiated (IRR) special requirement (21), common antibody with match expected at greater than 10% and other (18 each).
Of the 214 group O RBC transfused to non-O patients, primary causes were emergency release (56 units), inventory depletion (38), pediatric (25), other (24), IRR requirement (23), antibody with match expected at greater than 10% (15), phenotype matched protocol (10), and short date (9)

Conclusions:

System opportunities to improve include:

(1) reduce ONRBC par level by 1-2 units.

(2) add 1 group A-neg IRR unit for all sites and potentially 1 group B-neg IRR unit based on usage.

(3) add 1-2 group A-pos dependent on level of monthly transfusions.

(4) increase group O-pos IRR inventories by 3-6.

(5) simulate situations where RhD-pos RBC emergency release is permitted per policy and transition to type specific when testing is complete.

(6) report events where type and screen is not promptly collected.

(7) monitor inventory to send RBCs to the site with greatest usage at 5 or more days to outdate.

(8) reviewing patient situations with special requirements and/or antibodies and finding ABO specific units.

(9) monitoring transfusion reports for compliance.