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dc.contributor.authorCardigan, Rebecca
dc.contributor.authorLatham, Tom
dc.contributor.authorWeaver, Anne
dc.contributor.authorYazer, Mark
dc.contributor.authorGreen, Laura
dc.date.accessioned2022-01-28T14:38:28Z
dc.date.available2022-01-28T14:38:28Z
dc.date.issued2022-05
dc.date.submitted2021-10-28
dc.identifier.issn0042-9007
dc.identifier.othervox13249
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/332999
dc.description.abstractBACKGROUND AND OBJECTIVES: D-negative red cells are transfused to D-negative females of childbearing potential (CBP) to prevent haemolytic disease of the foetus and newborn (HDFN). Transfusion of low-titre group O whole blood (LTOWB) prehospital is gaining interest, to potentially improve clinical outcomes and for logistical benefits compared to standard of care. Enhanced donor selection requirements and reduced shelf-life of LTOWB compared to red cells makes the provision of this product challenging. MATERIALS AND METHODS: A universal policy change to the use of D-positive LTOWB across England was modelled in terms of risk of three specific harms occurring: risk of haemolytic transfusion reaction now or in the future, and the risk of HDFN in future pregnancies for all recipients or D-negative females of CBP. RESULTS: The risk of any of the three harms occurring for all recipients was 1:14 × 103 transfusions (credibility interval [CI] 56 × 102 -42 × 103 ) while for females of CBP it was 1:520 transfusions (CI 250-1700). The latter was dominated by HDFN risk, which would be expected to occur once every 5.7 years (CI 2.6-22.5). We estimated that a survival benefit of ≥1% using LTOWB would result in more life-years gained than lost if D-positive units were transfused exclusively. These risks would be lower, if D-positive blood were only transfused when D-negative units are unavailable. CONCLUSION: These data suggest that the risk of transfusing RhD-positive blood is low in the prehospital setting and must be balanced against its potential benefits.
dc.languageen
dc.publisherWiley
dc.subjectORIGINAL ARTICLE
dc.subjectORIGINAL ARTICLES
dc.subjectHDFN
dc.subjectlow‐titre group O whole blood
dc.subjectmajor haemorrhage
dc.subjectmassive transfusion
dc.subjectred cells
dc.subjecttrauma
dc.subjectwhole blood
dc.titleEstimating the risks of prehospital transfusion of D-positive whole blood to trauma patients who are bleeding in England.
dc.typeArticle
dc.date.updated2022-01-28T14:38:28Z
prism.publicationNameVox Sang
dc.identifier.doi10.17863/CAM.80423
dcterms.dateAccepted2021-12-22
rioxxterms.versionofrecord10.1111/vox.13249
rioxxterms.versionAO
rioxxterms.versionVoR
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
dc.contributor.orcidCardigan, Rebecca [0000-0001-6823-8937]
dc.identifier.eissn1423-0410
cam.issuedOnline2022-01-12


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