It is best practice to transfuse donor red cells that match with the same ABO group and Rh(D) type as the recipient.
Pretransfusion testing is required for red cells. Consult your laboratory service provider about your requirements for samples and request forms.
Transfusion recipients should receive red cell components that are compatible with their own ABO group. Incompatible transfusions can result in serious harm to or death of the recipient.
You can give alternative donor red cell groups to a recipient if supplies of identical ABO group are limited or unavailable.
| ABO Group Red Cell Compatibility | |||||
| Patient’s ABO blood group |
Compatible ABO blood group of red cells for transfusion |
Unit ABO Group** | |||
| O | A | B | AB |
||
| Unknown* | Use group O red cells. If the patient is a premenopausal female, use Group O Rh(D) negative red cells. Continue to provide group O red cells until the patient’s blood group is known. |
1 | |||
| O | O only | 1 | |||
| A | A or O | 2 | 1 | ||
| B | B or O | 2 | 1 | ||
| AB | AB or A or B or O | 4 | 3 | 2 | 1 |
|
Notes: *Example: in an emergency where there is insufficient time to perform a blood group test; **1 = primary choice; 2 to 4 = second, third and last choice where supply of ABO identical blood is limited. |
|||||
Red cell transfusions are usually matched for Rh(D) type so use Rh(D)-compatible blood whenever possible.
You can safely give Rh(D)-negative red cells to Rh(D)-positive recipients without any risk of immunisation to the Rh(D) antigen; but, the converse is not true.
In life-threatening emergencies, you can give Rh(D)-positive red cells to an Rh(D)-negative recipient; but, there is a risk of stimulating Anti-D production.
Consider the patient's sex and age because this will influence your decision for using Rh(D)-positive blood for Rh(D)-negative patients:
Avoid giving Rh(D)-positive blood to an Rh(D)-negative female child or woman of child-bearing age
You must only consider giving Rh(D)-positive red cells to these Rh(D)-negative groups following discussions with a Haematologist or a Blood Service Transfusion Medicine Specialist
Please consult with your laboratory service provider if you are uncertain. They can provide guidance and will help ensure the appropriate blood is selected. You must also notify the treating clinician.
In some states and territories, regional and some smaller metropolitan hospitals may only hold Group O Rh(D)-positive red cells. These units are for emergency use only (eg, in life threatening situations).
