(4) The expiration date of the blood should be noted, to be sure that the age
of the blood is acceptable for its intended use.
b. Choice of Blood When Group-Specific Blood Is Unavailable. When blood
of the recipient's ABO group is unavailable, transfusion with an alternate group, as
shown, is acceptable, but must be administered as RBCs, or. if whole blood, must be
shown to lack hemolvsins directed against cells of the patient's group.
______________Alternate Donor Group__________
A or B+
A2B with anti-A1
A2 or B+
A1B with anti-'HI'(O)
A1 or B+
* A patient with uninhabitable anti-'Hi'(O) should be transfused with blood of group A1.
+ Either group may be chosen, but only one of the two should be used for a given
recipient. Group A is usually more readily available, than group B. If blood of yet
another group is needed, use group O.
c. Changing to Group-Specific Blood After Transfusion of a Different ABO
(1) The decision to change back to group-specific blood at any time is best
based on the presence or absence of anti-A and/or anti-B in subsequent samples of the
recipient's blood. Fresh blood specimens should be obtained on the day of each
successive transfusion for evaluation. If crossmatches of a freshly drawn patient
sample with group-specific blood indicate compatibility, this blood may be issued.
Otherwise, transfusion with RBCs of a different ABO group should be continued.
Group-specific transfusions should not be infused through the same infusion set as was
used for transfusion of red cells of a different ABO group.
(2) When the emergency is over, the effect of transfused alloantibodies
should be evaluated. Such antibodies may cause hemalysis of recipient cells.
If Rh-negative blood is unavailable; transfuse Rh-positive blood, rather than withholding
blood from a patient, whose need for blood is critical.
(3) Up to 70 percent of Rh-negative patients given Rh-positive blood may
form anti-RhO(D). It is reasonable to attempt prevention of immunization with large
doses of RhO(D) lmmune Globulin (Human) when only one unit of Rh-positive blood has
been given accidentally. One dose (approximately 300 ug) of RhO(D) lmmune Globulin
(Human) is required for 15 ml of RBCs; thus, 15 to 20 ml of Rh lmmune Globulin may be
required to prevent immunization by one unit of blood. Rh-negative blood may be given
to an Rh- positive recipient, if necessary.