Using Blood Donor-Derived ABO and RhD Blood Groups Helps to Detect Wrong Blood in Tube Errors in Recipients

Abstract

Background: Comparing the ABO and RhD group of a recipient's current pre-transfusion sample against their historical group is an important means of detecting wrong blood in tube (WBIT) errors. This study investigated the utility of using the donor ABO and RhD group as the historical check for recipients. Methods: A single database stores serological information on blood donors, pregnant women, and patients throughout southern Denmark. A donor ABO and RhD group can be the historical blood group should that donor later require a transfusion. This database was searched to determine how often the ABO and RhD group on a recipient's current pre-transfusion sample was discrepant with their historical donor-derived blood group. Results: During about 21 years, ABO and RhD groupings were performed on 76,455 blood donors and on 424,697 patients. There were 13,630/424,697 (3.2%) patients who had their donor-derived ABO and RhD group used as the historical comparison with the current sample; 6/13,630 (0.04%) of the current pre-transfusion samples on these patients were discrepant with the donor-derived historical group because of WBIT errors. Seven other discrepancies with the donor-derived blood group were also found. Conclusion: Accessing the donor-derived ABO and RhD group can be an important safeguard against WBIT-mediated mistransfusions.

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“…Potential alternative solutions to the group check sample are the use of electronic multiparameter delta checks comparing the current sample metrics to samples from the preceding 72 hours (e.g., are the blood count and chemistry results different enough to suggest they were drawn from a different patient? ), integration of multiple regional blood bank information systems (to compare blood groups across multiple laboratories), and utilization of blood donor blood group databases to minimize the number of group check sample draws . Multiparameter delta checks would be considerably cheaper than the group check sample if found to be highly sensitive and specific for mislabeled samples, with the additional benefit of detecting wrong patient events when a blood group sample is not drawn.…”

“…), 33 integration of multiple regional blood bank information systems (to compare blood groups across multiple laboratories), 34 and utilization of blood donor blood group databases to minimize the number of group check sample draws. 35 Multiparameter delta checks would be considerably cheaper than the group check sample if found to be highly sensitive and specific for mislabeled samples, with the additional benefit of detecting wrong patient events when a blood group sample is not drawn.…”