Comparison of outcomes of group o vs non-group o premature neonates receiving group o rbc transfusions

Leonard I. Boral, Zane G. Staubach, Reny De Leeuw, Duncan C. MacIvor, Richard Kryscio, Henrietta S. Bada

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Objectives: At some institutions all infants requiring RBC transfusions in neonatal intensive care units (NICUs) receive only group O RBCs. Although transfused group O plasma is minimized in packed RBCs, small amounts of residual anti-A, anti-B, and anti-A,B in group O packed RBCs may bind to the corresponding A and B antigens of non-group O RBCs, possibly hemolyzing their native RBCs and thereby releasing free hemoglobin, theoretically resulting in hypercoagulability and promoting bacterial growth from free iron. Methods: Premature infants in the University of Kentucky Children's Hospital NICU database who were transfused (all received group O transfusions) were compared for a number of severity markers to determine if non-group O patients had worse outcomes than group O patients. Results: In this NICU sample, 724 neonates received at least 1 blood component. No significant differences were found between group O and non-group O infants with regard to final disposition or complications. Conclusions: This reassuring finding validates the longstanding neonatal transfusion practice of using group O packed RBCs for infants of all blood groups in the NICU. However, a recent study shows increased mortality from necrotizing enterocolitis in group AB neonates at a facility transfusing only group O RBCs to neonates of all blood groups and suggests a change in neonatal transfusion practice to ABO group-specific RBCs; therefore more studies may be warranted.

Original languageEnglish
Pages (from-to)780-786
Number of pages7
JournalAmerican Journal of Clinical Pathology
Issue number6
StatePublished - Dec 2013


  • Group O transfusion
  • NICU
  • Non-group O
  • RBC transfusions

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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