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Background/Case Studies: Group O red blood cells (RBCs) are the universal donor red cells; they can be given to a recipient with any other blood group. Although it is usually the standard practice to select ABO group specific blood as the first choice for patients requiring transfusion, there are many situations where group O blood is given to non-O recipients. Transfu-sion of group O blood to non-O recipients, or the transfusion of Rh negative (D-) blood to Rh positive (D1) recipients, can result in shortages of O or D-blood, respectively. Current patterns of group O and D- blood utilization are not well understood. Study Design/Methods: Hospital transfusion services collected ABO and Rh groups of transfused RBC units and of recipients during the 2013 calendar year. Units administered to recipients of unknown ABO or Rh group were excluded. Two analyses were performed: How often group O RBCs were transfused to non-O recipients, and how often D- units (of any ABO group) were transfused to D1 recipients. The hospitals were divided into 3 categories: Small (<250 beds), medium (250-1000 beds), and large (>1000 beds). Results/Findings: Data was received from 30 centers in 9 countries. There were 7 small, 17 medium and 6 large hospital respondents. In total, these 30 centers transfused a total of 415,696 RBC units, of which 2257 (0.5%) were units excluded from the D mismatch analysis because the D type of the recipient was unknown. The ABO groups of all recipients were known. Overall 11.1% of the O units were transfused to non-O recipients. The percentage of O RBCs transfused to non-O recipients was similar among the small, medium and large sized hospital respondents (12.4, 12.8 and 8.5%, respectively). The rate of group O RBC transfusion to non-O recipients at the small hospitals ranged from 0-33.0%, at the medium hospitals from 0-22.0%, and at the large hospitals from 5.0-10.0%. In terms of D- RBC transfusion to D1 recipients, overall 29.8% of the D- units were transfus

BACKGROUND: Transfusion of group O blood to non-O recipients, or transfusion of D- blood to D+ recipients, can result in shortages of group O or D- blood, respectively. This study investigated RBC utilization patterns at hospitals around the world and explored the context and policies that guide ABO blood group and D type selection practices. STUDY DESIGN AND METHODS: This was a retrospective study on transfusion data from the 2013 calendar year. This study included a survey component that asked about hospital RBC selection and transfusion practices and a data collection component where participants submitted information on RBC unit disposition including blood group and D type of unit and recipient. Units administered to recipients of unknown ABO or D group were excluded. RESULT(S): Thirty-eight hospitals in 11 countries responded to the survey, 30 of which provided specific RBC unit disposition data. Overall, 11.1% (21,235/191,397) of group O units were transfused to non-O recipients; 22.6% (8777/38,911) of group O D- RBC units were transfused to O D+ recipients, and 43.2% (16,800/38,911) of group O D- RBC units were transfused to recipients that were not group O D-. Disposition of units and hospital transfusion policy varied within and across hospitals of different sizes, with transfusion of group O D- units to non-group O D- patients ranging from 0% to 33%. CONCLUSION(S): A significant proportion of group O and D- RBC units were transfused to compatible, nonidentical recipients, although the frequency of this practice varied across sites.Copyright © 2017 AABB