Improved allocation strategies for red cell units of blood group O and RhD-negative revealed by current suboptimal utilization.

backgroundDemand for O RhD-negative red cells continues to rise, while overall red cell transfusions have decreased, compounding inventory management challenges. We analyzed O RhD-negative red cell utilization in a large publicly available database.

methodsData from 378,855 red cell transfusions were evaluated using the Recipient Epidemiology and Donor Evaluation Study-III (REDS-III). Utilization patterns, recipient demographics, and their correlation with the age of red cell units at transfusion were examined.

resultsThe majority of O RhD-negative units were transfused to patients with blood groups other than O RhD-negative (54.5%). A larger percentage of O RhD-negative red cells were transfused after 35 days of collection (41%), compared to other blood groups (18.7%). Patients over 50 years, males, non-O RhD-negative and RhD-positive individuals had higher odds of receiving units stored more than 35 days. Patients with higher hemoglobin concentrations were more likely to receive older blood units. DISCUSSION: The analysis identified opportunities to improve the allocation of O RhD-negative red cell units, highlighting current inventory practices as suboptimal. The findings call for refined allocation strategies to improve the utilization of this limited resource. The implementation of real-time management approaches may balance the retention of such red cell units with the needs of patients who benefit from the use of RhD-negative blood.