Transfusion of ABO-Group Identical Red Blood Cells Following Uncrossmatched Transfusion Does Not Lead to Higher Mortality in Civilian Trauma Patients

Authors

Mark H. Yazer, Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. Vitalant, Pittsburgh, Pennsylvania, USA.
Nancy M. Dunbar, Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.
John R. Hess, Department of Laboratory Medicine and Pathology, Seattle, Washington, USA.
Erin E. Tuott, Department of Laboratory Medicine and Pathology, Seattle, Washington, USA.
Mohammad Bahmanyar, Department of Pathology and Laboratory Medicine, Royal Columbian Hospital, New Westminster, British Columbia, Canada.
Jessica Campbell, Wing-Kwai and Alice Lee-Tsing Chung Transfusion Service, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, UCLA (University of California, Los Angeles), Los Angeles, California, USA.
Magali Fontaine
Ara Ko, Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Jian Mi, Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Michael F. Murphy, NHS Blood & Transplant and Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
Jessica Poisson, Department of Pathology, Duke University, Durham, North Carolina, USA.
Jay S. Raval, Department of Pathology, University of New Mexico, Albuquerque, New Mexico, USA.
Andrew W. Shih, Department of Pathology and Laboratory Medicine, Vancouver General Hospital, Vancouver, British Columbia, Canada.
Jason L. Sperry, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Julie Staves, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
Michelle Wong, Department of Pathology and Laboratory Medicine, Royal Columbian Hospital, New Westminster, British Columbia, Canada.
Matthew T S Yan, Department of Pathology and Laboratory Medicine, Royal Columbian Hospital, New Westminster, British Columbia, Canada.
Alyssa Ziman, Wing-Kwai and Alice Lee-Tsing Chung Transfusion Service, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, UCLA (University of California, Los Angeles), Los Angeles, California, USA.
Jansen N Seheult, Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. Vitalant, Pittsburgh, Pennsylvania, USA.

Document Type

Article

Publication Date

5-1-2023

Abstract

BACKGROUND: Questions persist about the safety of switching non-group O recipients of group O uncrossmatched red blood cells (RBC) or low titer group O whole blood (LTOWB) to ABO-identical RBCs during their resuscitation.

METHODS: The database of an earlier nine-center study of transfusing incompatible plasma to trauma patients was reanalyzed. The patients were divided into three groups based on 24-h RBC transfusion: (1) group O patients who received group O RBC/LTOWB units (control group, n = 1203), (2) non-group O recipients who received only group O units (n = 646), (3) non-group O recipients who received at least one unit of group O and non-group O units (n = 562). Fixed marginal effect of receipt of non-O RBC units on 6- and 24-h and 30-day mortality was calculated.

RESULTS: The non-O patients who received only group O RBCs received fewer RBC/LTOWB units and had slightly but significantly lower injury severity score compared to control group; non-group O patients who received both group O and non-O units received significantly more RBC/LTOWB units and had a slightly but significantly higher injury severity score compared to control group. In the multivariate analysis, the non-O patients who received only group O RBCs had significantly higher mortality at 6-h compared to the controls; the non-group O recipients of O and non-O RBCs did not demonstrate higher mortality. At 24-h and 30-days, there were no differences in survival between the groups.

CONCLUSION: Providing non-group O RBCs to non-group O trauma patients who also received group O RBC units is not associated with higher mortality.

Recommended Citation

Yazer MH, Dunbar NM, Hess JR, Tuott EE, Bahmanyar M, Campbell J, Fontaine M, Ko A, Mi J, Murphy MF, Poisson J, Raval JS, Shih AW, Sperry JL, Staves J, Wong M, Yan MTS, Ziman A, Seheult JN. Transfusion of ABO-group identical red blood cells following uncrossmatched transfusion does not lead to higher mortality in civilian trauma patients. Transfusion. 2023 May;63 Suppl 3:S46-S53. doi: 10.1111/trf.17322. Epub 2023 Apr 17. PMID: 36971017.