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Posted on 06 Mar 2023
Clinical/acute care

In response to the ongoing severe shortage of O RhD negative RBC in Australia, the National Blood Authority has prepared a National Statement for the Emergency Use of Group O RBC, which includes the use of group O RhD positive RBC.

This statement can be accessed on the National Blood Authority website.

Historically, O RhD negative red blood cells (RBC) have been used for all emergency transfusions despite most of the Australian population being RhD phositive. Group O RBC enable a patient to survive a life-threatening situation.

The current demand for group O RhD negative red blood cells is 16.2 per cent of all RBC issued, whereas only 8.7 per cent of new Australian donors are O RhD negative (current as of September 2022). Throughout 2022, this has resulted in serious, prolonged and ongoing shortages of O RhD negative RBC, which have impacted health services.

Large numbers of O RhD negative RBC are held for emergency use. However, most are not used for emergency purposes. Often, O RhD negative RBC are electively transfused to non-Group O RhD negative patients to ensure the RBC do not expire (Blood Matters 2018).

Recommendations for emergency use of group O red blood cells

To align Victoria with the National Statement, we have worked with Blood Matters for endorsement, education, and promotion of the appropriate emergency use of group O RBC. Resources and support tools to assist health services implement the recommendations are available for download from Blood Matters

The following recommendations have been introduced to reduce the demand for group O RhD negative RBC.

Where the patient’s blood group is unknown:

  • group O RhD positive RBCs to be issued for females > 50 years and males >18 years (or based on organisational definition of paediatrics)
  • group O RhD negative RBCs to be issued for females of childbearing potential (≤50 years, including children) and males ≤18 years.

Where the person’s age or sex cannot be determined, clinical judgement should prevail.