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CC BY-NC-ND 4.0 · AJP Rep 2024; 14(02): e129-e132
DOI: 10.1055/s-0044-1786712
Short Communication

Low-Titer Type O Whole Blood for Transfusing Perinatal Patients after Acute Hemorrhage: A Case Series

Nicholas R. Carr
1   Division of Neonatology, Department of Pediatrics, University of Utah, Salt Lake City, Utah
,
Timothy M. Bahr 
1   Division of Neonatology, Department of Pediatrics, University of Utah, Salt Lake City, Utah
2   Obstetric and Neonatal Operations, Intermountain Healthcare, Murray, Utah
,
Robin K. Ohls
1   Division of Neonatology, Department of Pediatrics, University of Utah, Salt Lake City, Utah
,
Sarah M. Tweddell 
1   Division of Neonatology, Department of Pediatrics, University of Utah, Salt Lake City, Utah
,
David S. Morris
3   Division of Trauma, Intermountain Medical Center Murray, UT and Department of Surgery, University of Utah, Salt Lake City, Utah
,
Terry Rees
4   Intermountain Healthcare Transfusion Services and Department of Pathology, Intermountain Medical Center, Murray, Salt Lake City, Utah
,
Sarah J. Ilstrup
4   Intermountain Healthcare Transfusion Services and Department of Pathology, Intermountain Medical Center, Murray, Salt Lake City, Utah
,
Walter E. Kelley
5   American National Red Cross, Salt Lake City, Utah
6   Department of Pathology, University of Arizona College of Medicine, Tucson, Arizona
,
Robert D. Christensen
1   Division of Neonatology, Department of Pediatrics, University of Utah, Salt Lake City, Utah
2   Obstetric and Neonatal Operations, Intermountain Healthcare, Murray, Utah
› Author Affiliations Funding None.
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Abstract

Objective Acute and massive blood loss is fortunately a rare occurrence in perinatal/neonatal practice. When it occurs, typical transfusion paradigms utilize sequential administration of blood components. However, an alternative approach, transfusing type O whole blood with low anti-A and anti-B titers, (LTOWB) has recently been approved and utilized in trauma surgery.

Study Design Retrospective analysis of all perinatal patients who have received LTOWB after acute massive hemorrhage at the Intermountain Medical Center.

Results LTOWB was the initial transfusion product we used to resuscitate/treat 25 women with acute and massive postpartum hemorrhage and five infants with acute hemorrhage in the first hours/days after birth. We encountered no problems obtaining or transfusing this product and we recognized no adverse effects of this treatment.

Conclusion Transfusing LTOWB to perinatal patients after acute blood loss is feasible and appears at least as safe a serial component transfusion. Its use has subsequently been expanded to multiple hospitals in our region as first-line transfusion treatment for acute perinatal hemorrhage.

Key Points

Low-titer type O whole blood (LTOWB) was our initial transfusion product for 30 perinatal patients with acute hemorrhage. Twenty-five of these were obstetrical patients and five were neonatal patients. We encountered no problems with, or adverse effects from LTOWB in any of these patients. LTOWB transfusions to women were ten days since donor draw (interquartile range, 8–13) and to neonates was six days (5–8).

Keywords

transfusion - whole blood - perinatal - neonatal - hemorrhage

Author Contributions

N.R.C., T.M.B., R.K.O., S.J.I., W.E.K., and R.D.C. contributed in conception and design, assembly of data, manuscript writing, final approval of the manuscript. S.M.T., D.S.M., and T.R., contributed in conception and design and final approval of the manuscript.




Publication History

Received: 08 November 2023

Accepted: 27 March 2024

Article published online:
03 May 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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