Journal of Blood Disorders & Transfusion

Abstract

The Appropriate Use of O RhD Positive Units in RhD Negative Patients: A Systematic Review and Meta-Analysis

Leung W, Quiring S and Denise E Jackson*

The increasing use of O RhD-negative Red Blood Cells (RBCs) in transfusion practise requires a sustainable approach. We investigate the incidence of RhD alloimmunisation in RhD-negative patients to determine the efficacy and thereof the efficiency of using O RhD-positive as part of adapting protocols.

PubMed, Scopus, EMBASE and Google Scholar were used to search for relevant articles between August 2019 to August 2024 for articles with the use of RhD-positive RBCs in RhD-negative trauma patients.

Of 6 studies (458 cases) included in the meta-analyses, the incidence of RhD alloimmunisation of RhD-patients when given at least one RhD-positive RBC was 16.4% (CI 95%, 5.6%-31.3%). In the same studies, using eligible data, we found the incidence of non-RhD alloimmunisation in RhD-negative patients given RhD-positive RBCs (207 cases) to be 7.3% (CI 95%, 2.8%-13.6%) compared with non-RhD alloimmunisation in patients given RhD-negative RBCs (2119 cases) at 6.4% (CI 95%, 3.4%-10.3%).

The risk of RhD alloimmunisation given the protocols in place and the population frequency of RhD-positive individuals in Australia is minimal and not dissimilar to the alloimmunisation of non-RhD antibodies. Recommendations for the use of O RhD-positive RBCs in emergency transfusion remains a safe and viable alternative in the conservation of O RhD-negative RBCs.

Published Date: 2024-02-21; Received Date: 2024-01-15