Cherish the O-negative Red Blood Cells

by Carter BloodCare Specialty Services

by L. Sutor, M.D., Vice President of Medical and Technical Services, Carter BloodCare

The challenge continues for us to meet community needs for group O Rh-negative red blood cells (RBCs), despite Carter BloodCare’s collecting group O blood at increasing efficiency (see graph). Demand continues to outpace supply. Our individual hospitals have requested up to 28 percent O-negative units (10.54 percent average actually delivered for our entire service area in 2015), despite donors with group O-negative blood comprising at most 6.75 percent of our community population.

What is causing this increase in demand?

Several factors may account for the increase in ordering, or in use of O-negative units in our community. The table below outlines the issue.

Possible causes of blood group O-negative RBC demand:

  • Increased trauma use

  • Increased use of massive transfusion protocols

  • CAP (College of American Pathologists) requirement to double check blood type before switching types

  • Use of O-negative RBCs to get “rare” or antigen-negative units

  • Persistent high blood-bank inventories, despite decreased hospital use over 3-5 years

  • Use of O-negative RBCs for non-O-blood-group patients, to keep units from expiring

  • Increased specialty patient populations

  • Irradiated unit inventories that are all group O

What can we all do?Carter BloodCare, facing “donor fatigue” and inability to import group O Rh-negative units from other blood centers, is looking at innovative ways to recruit lapsed and new donors. We also continually strive to minimize any wastage or outdates on our own shelves. We have released to general inventory a percentage of the antigen-negative, O-negative units we previously held routinely on site, for matching patients with multiple red cell antibodies.

We urge Carter BloodCare client hospitals to look at their ordering, transfusion and stocking policies to ensure that we are being good stewards of this valuable community resource. If you have any good ideas for the O-negative dilemma, please contact Medical Services or Hospital Relations representative Veronica Moore.