The distribution of ABO RhD blood groups in Australia, based on blood donor and blood sample pathology data

Abstract

ustralian Red Cross Lifeblood is the national supplier of fresh blood and blood products to the Australian community, produced from voluntary, non-remunerated blood donations. In Australia, as elsewhere, overall demand for red blood cells (RBCs) has declined over the past ten years, but the demand for universal RBC units -ie, from group O RhD-negative (RhD-) donors -has increased. 1,2 To ensure an adequate supply of O RhD-RBC units, Lifeblood dedicates resources to recruiting and retaining O RhD-donors.The only available data on ABO RhD blood group prevalence in Australia are based on information for first-time blood donors during 1993-94. 3 The demographic characteristics of Australia have changed substantially in the meantime, the population having increased by 7.5 million people to 2019, 4 including three million migrants, predominantly from South East Asia, India, and China. 5 Understanding migration patterns is important for blood collection planning, as the distribution of ABO RhD blood groups differs between ethnic groups. 6,7 As recent national data on ABO RhD blood group prevalence in Australia are not available, it is unknown whether supply for high demand blood and blood products can be sustained.The most recent information on ABO RhD blood group prevalence was collected in the Northern Territory and Western Australia to support clinical care for Indigenous Australians. 8,9 However, data for these two jurisdictions cannot be generalised to all parts of Australia. National data are needed to provide accurate information for planning the supply of blood and blood products, to reduce clinical waste, and to ensure blood collection patterns match community demand.We aimed to determine the distribution of ABO RhD blood groups in Australia. We analysed Lifeblood information for blood donors, but these data are biased by disproportionally high collection from certain donors to meet clinical demand for specific blood groups, such as group O RhD-for RBC units and group AB blood for plasma. We therefore also assessed blood group data provided by national pathology agencies. MethodsWe undertook our study during 1 January -31 December 2019. The Lifeblood national transfusion scientific team contacted 41 pathology agencies (representing 324 health providers approved by the National Blood Authority to receive blood and blood products from Lifeblood) by email, using internal communications distribution lists. The pathology agencies covered all approved health providers in metropolitan, regional, and rural areas in all eight states and territories of Australia.Participating agencies provided ABO RhD blood group data for all patients during 2019 for whom pathology analysis included blood typing. We did not collect information about the blood typing methods and equipment used by individual services. Patient age, sex assigned at birth, and residential postcode could also be supplied, but these details were optional. We specifically requested that duplicate results for patients be removed, but we could not check dupli...

Profile of blood donors in a hemotherapy institution in Midwestern Brazil

“…Regarding ABO and Rh factor systems, based on samples typed by pathology services in Australia, the blood group prevalence was as follows: O RhD+, 38.4%; O RhD-, 6.5%; A RhD+, 32.0%; A RhD-, 5.6%; B RhD+, 11.8%; B RhD-, 1.5%; AB RhD+, 3.7%; and AB RhD-, 0.5% 21 . In the Brazilian national territory, 43.15% had O RhD+ blood type, and 29.25% had A RhD+ blood type as the most prevailing ones, and blood types AB RhD-(0.4%) and B RhD-(1.29%) as minorities 9 , presenting similarities with our study, which may be related to the fact that the gene-determining Rh+ is dominant and the gene determining Rh-is recessive.…”

The other parts of the blood group alphabet: meeting the diverse requirements of our changing population

“…People who require chronic red cell transfusion support must be provided with ABO‐compatible blood, placing pressure on ensuring that supply matches the required blood groups, as highlighted by Hirani and colleagues 1 . Red cells also express a variety of non‐ABO antigens; 43 distinct human blood group systems are recognised (including the Rh, Kell, Kidd, Duffy, and MNS systems), and more than 300 antigens 4 .…”

“…Lifeblood, a branch of the Australian Red Cross, has supplied clinically critical blood products for more than 90 years and continues to maintain the highest standards of quality and safety. In this issue of the MJA , Lifeblood researchers Hirani, Weinert and Irving report their findings on the prevalence of ABO RhD blood groups in the community, including the increasing proportion of RhD‐positive first‐time blood donors, reflecting the changing ethnic make‐up of the Australian population 1 …”

“…Demand for red cells in Australia increased during the coronavirus disease 2019 (COVID‐19) pandemic, while blood donations declined. The demand for O RhD‐negative stock accounted for 17.4% of total red cells supplied during 2019 1 and for 16.4% during the 2021 calendar year (personal communication, Joanne Pink, Red Cross Lifeblood, February 2022). Only 8.7% of first‐time donors in 2019 were group O RhD‐negative 1 .…”

“…The demand for O RhD‐negative stock accounted for 17.4% of total red cells supplied during 2019 1 and for 16.4% during the 2021 calendar year (personal communication, Joanne Pink, Red Cross Lifeblood, February 2022). Only 8.7% of first‐time donors in 2019 were group O RhD‐negative 1 . This discrepancy between supply and demand places enormous pressures on our blood supply, and could affect care planning, including for the provision of emergency stocks in rural and remote areas.…”