Routine transfusion of Rh(D)-positive RBCs to Rh(D)-negative patients designated as do not resuscitate conserves Rh(D)-negative red blood cell inventory.
Publication/Presentation Date
6-1-2026
Abstract
BACKGROUND: A minority of blood donors are Rh(D)-negative, and Rh(D)-negative red blood cell (RBC) products are often overutilized. As such, Rh(D)-negative RBCs may be difficult to maintain in blood bank inventory.
STUDY DESIGN AND METHODS: We changed our blood bank laboratory policy to approve non-alloimmunized Rh(D)-negative patients to receive Rh(D)-positive RBCs for routine transfusion under defined criteria. Those criteria included Rh(D)-negative males (all ages) and females (aged >50 years) who were designated as do not resuscitate (DNR), either with or without intubation, in the electronic medical record.
RESULTS: From August 15, 2024 through August 15, 2025, a total of 204 Rh(D)-negative patients met the above criteria and were approved to receive routine Rh(D)-positive RBC transfusions. Within that group, 23 patients received Rh(D)-positive RBCs. The remaining patients either did not require transfusion or were issued Rh(D)-negative RBC units. Since implementing this practice, a total of 68 Rh(D)-negative units were conserved during this time frame. Notably, 28 of the 68 units (41%) were type O, Rh(D)-negative.
DISCUSSION: Rh(D)-positive RBCs can be routinely given to non-alloimmunized Rh(D)-negative patients who are not at risk for developing hemolytic disease of the fetus and newborn (HDFN). By creating clear guidelines for the routine administration of Rh(D)-positive RBCs to patients who are not at risk for HDFN, the inventory of Rh(D)-negative RBC units can be directed to those patients who would most benefit from this limited resource.
Volume
66
Issue
6
First Page
1108
Last Page
1112
ISSN
1537-2995
Published In/Presented At
Karp, J. K., Everetts, J., Guarente, J., Vivero, A., Bohr, T., & Harach, M. (2026). Routine transfusion of Rh(D)-positive RBCs to Rh(D)-negative patients designated as do not resuscitate conserves Rh(D)-negative red blood cell inventory. Transfusion, 66(6), 1108–1112. https://doi.org/10.1111/trf.70209
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
41968474
Department(s)
Administration and Leadership
Document Type
Article