Recently a clinician roundtable of the Alliance for a Strong Blood Supply met to review the overuse of the universal blood type O and discuss strategies to increase blood supply nationwide during this ongoing shortage. The CAP, along with 16 other hospital, medical and laboratory groups, are members of the Alliance for a Strong Blood Supply, a coalition of organizations committed to ensuring sufficient blood is available for all patients during the pandemic and beyond. The Association for the Advancement of Blood & Biotherapies (AABB) launched the Alliance to address current challenges with the nation’s blood supply. The CAP advocates for a safe blood supply for patients and communities across the United States.

The group met on March 3 to share best practices aimed at supporting the stewardship of the blood supply. Glenn E. Ramsey, MD, FCAP, Chair of the CAP Transfusion, Apheresis, and Cellular Therapy Committee, represented the CAP at this meeting, where the group discussed the overuse of the universal blood Type O. Type O blood is in high demand during this blood supply shortage as it may be transferred safely to recipients of any ABO Rh(D) type. However, this overuse of the universal donor O blood could lead to critical shortages, limiting the supply for patients who need it.

The group discussed the following recommendations to ensure appropriate blood type O use:

1. Group O should be reserved for three cohorts of females of childbearing potential: those who are group O Rh(D)-negative, those who are Rh(D)-negative requiring transfusion when type-specific blood is unavailable, and those of unknown blood type who require red blood cell (RBC)s before the completion of pretransfusion testing.
2. Hospital transfusion services should closely monitor with the current use of Rh(D)-negative inventory blood supply. Hospitals should develop policies now that describe when patients should be switched to Rh(D)-positive RBCs to avoid depletion of the group O Rh(D)-negative supply.
3. Hospitals should have protocols to expedite sample collection to quickly switch patients to type-specific blood upon completion of pretransfusion testing.

Regions throughout the United States are currently facing significant blood supply challenges, with many blood collectors operating with less than a one-day supply on hand, which is below the ideal goal of at least a three-day supply. As a result, hospitals have been forced to delay life-saving blood transfusions and postpone nonessential surgeries.