Patients with non-ABO red blood cell antibodies: transfusion best practices for professionals

When a patient who needs a red blood cell transfusion has unexpected red blood cell antibodies (non-ABO) in their blood, health-care providers have to make decisions about what kind of red blood cell units can be safely transfused. Finding the right match for the patient is crucial because in some cases, transfusing incompatible donor units — those with antigens that could react with the patient’s antibodies — can result in serious complications, including acute or delayed hemolytic transfusion reactions. When pregnant mothers have these unexpected antibodies, they may require specialized prenatal care because their fetus or newborn may be at risk for a potentially life-threatening disease called hemolytic disease of the newborn.

To support hospital transfusion services and health-care providers in making clinical decisions that optimize patient care and use of blood products, Canadian Blood Services published new serological best practices on its professional education website. Dr. Gwen Clarke, associate medical director of clinical services at Canadian Blood Services and clinical professor in the University of Alberta’s department of laboratory medicine and pathology, collaborated with resident physicians from the University of Alberta Hematological Pathology residency training program to develop the best practices. Included are recommendations for selecting donor red blood cell units and other guidance to ensure transfusion patients receive red blood cell units that are the best match for them while avoiding requests for antigen-matched units or additional testing when these are not required.

For more resources for health-care providers, including leading practices and clinical guidelines, visit Canadian Blood Services' professional education website. 

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The opinions reflected in this post are those of the author and do not necessarily reflect the opinions of Canadian Blood Services nor do they reflect the views of Health Canada or any other funding agency.