Transfusion Medicine最新文献

{"title":"Burden of transfusion-transmitted infections among patients with thalassaemia and sickle cell anaemia in India: A systematic review and meta-analysis.","authors":"Vaibhav Shandilya, Savitha Seetharaman, Sahana Parmeswaraiah Geetha, Divjot Singh Lamba, Soumya Das, Bijaya Kumar Padhi, Aravind P Gandhi","doi":"10.1111/tme.70044","DOIUrl":"10.1111/tme.70044","url":null,"abstract":"<p><p>Lifelong blood transfusions, crucial for severe cases of thalassaemia and sickle cell disease (SCD), contribute to a high risk of transfusion-transmitted infections (TTIs). The current systematic review and meta-analysis determined the prevalence of transfusion-transmitted infections (TTIs) among patients with thalassaemia and sickle cell anaemia in India. A systematic search was conducted in PubMed, Scopus, ProQuest, EMBASE and Web of Science for articles published up to September 13, 2025. Title abstract screening followed by full-text review and data extraction was done by two independent reviewers. Risk of bias was assessed for the included studies. Meta-analysis was conducted to estimate the pooled prevalence of TTIs. The systematic review and meta-analysis identified 397 unique articles, with 39 selected for full-text review. After exclusions, 24 studies spanning from 1990 to 2023 were included. All 24 studies included patients with beta thalassaemia, whereas only one study had data on sickle cell anaemia patients, so this review focuses mainly on the prevalence of TTI in patients with beta thalassaemia. The pooled prevalence of Hepatitis C was 22% (95% CI: 14%-30%; I² = 96%), Hepatitis B was 8% (95% CI: 2%-16%; I² = 96%) and HIV was 4% (95% CI: 2%-7%; I² = 77%) in beta-thalassaemia patients, all showing high heterogeneity. Meta-regression revealed a statistically significant decline over time in HBV (Beta = -0.0194, p = <0.01) while Hepatitis C prevalence (Beta = -0.0025, p = 0.6642) and HIV showed no significant trend (Beta = -0.0001, p = 0.9839). Significant burden of TTIs is present among transfusion-dependent thalassaemia and sickle cell anaemia patients in India. Strengthening screening protocols, improving vaccination coverage and implementing targeted healthcare interventions are essential to mitigate this preventable risk.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"121-132"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145640327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterisation of RHD and RHCE variations in blood donors from Jazan Province, Southwestern Saudi Arabia.","authors":"Maymoon M Madkhali, Mayisah Khormy, Abdullah A Meshi, Bandar Kameli, Khaled Ghazwani, Ohoud Sufyani, Salha Hakami, Yahya Khawaji, Abdullah A Mobarki, Khaled Essawi, Waleed Hakami, Yara Alyahyawi, Aymen M Madkhali, Gasim Dobie, Hassan A Hamali","doi":"10.1111/tme.70040","DOIUrl":"10.1111/tme.70040","url":null,"abstract":"<p><strong>Background and objectives: </strong>Rh is among the most important and highly polymorphic blood group systems due to the proximity of the RHD and RHCE genes, which encode numerous highly immunogenic antigens. However, in areas of Saudi Arabia with a high prevalence of hemoglobinopathy, the molecular characteristics of RHD and RHCE variations are lacking. This study focuses on characterizing the allelic and genotypic distributions of RHD and RHCE blood donors in Jazan, Saudi Arabia.</p><p><strong>Materials and methods: </strong>All blood donors' records between June 2023 and December 2024 were reviewed. ID RHD XT was applied for 60 negative or weak RhD Saudi donors, while 354 Saudi and 110 non-Saudi donors received RHCE genotyping using the ID CORE XT.</p><p><strong>Results: </strong>RHD deletion accounted for 76.7% of the RhD-negative donors. RHCE*Ce (44.1%) was the most common RHCE allele in Saudis, followed by RHCE*ce (31.9%) and RHCE*cE (12.3%). Variant alleles including RHCEce*(733G), RHCEce*(733G,1006T), RHCE*ceAR, RHCE*ce(712G), and RHDr's-RHCE*ce(733G,1006T) were detected in 11.72% in Saudi and 7.73% in non-Saudi, while low- and high-frequency antigens V, hrS, VS, and hrB were observed in Saudis with frequencies of 21.8%, 97.8%, 24.8%, and 93.2%, respectively. RHCE*ce/RHCE*Ce was the most prevalent genotype (26.8%). The non-Saudi group displayed similar profiles, with RHCE*Ce (48.2%), RHCE*ce (30.9%), and RHCE*cE (13.2%). There were no significant differences between Saudi and non-Saudi allele or genotype distributions using Fisher's exact test.</p><p><strong>Conclusion: </strong>The study represents the first molecular characterisation of RHD and RHCE alleles in Saudi Arabia, revealing marked allelic and genotypic diversity, with important implications for transfusion safety in the Jazan region, where hemoglobinopathies are prevalent.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"158-164"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145378696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart rate changes after phlebotomy in polycythaemia vera and healthy donors: An observational case-crossover pilot study.","authors":"Rik P B Tonino, Elisabeth M J Huis In 't Veld, Martin R Schipperus, Jaap Jan Zwaginga","doi":"10.1111/tme.70038","DOIUrl":"10.1111/tme.70038","url":null,"abstract":"<p><strong>Background: </strong>Haemoglobin plays a crucial role in oxygen transport, and any acute deviation will trigger compensatory hemodynamic functions. While the consequences of anaemia are well documented, the effects of haemoglobin reduction in individuals without anaemia remain less explored. Patients with polycythaemia vera and healthy blood donors, who both undergo regular phlebotomies, offer a valuable model for studying these effects.</p><p><strong>Methods: </strong>This observational case-crossover study assessed short-term physiological and quality-of-life changes following phlebotomy in five patients with polycythaemia vera and six healthy blood donors. Participants were remotely monitored using a smartwatch and completed daily quality-of-life assessments. The primary outcome was heart rate, while secondary outcomes included step count and quality-of-life measures.</p><p><strong>Results: </strong>Patients with polycythaemia vera exhibited stable heart rates, with only minor variations in physical activity and quality of life after phlebotomy. In contrast, healthy blood donors experienced a significant increase in heart rate, which returned to baseline within a week. Physical activity remained clinically unchanged in both groups, and quality-of-life scores were stable.</p><p><strong>Conclusions: </strong>This pilot study demonstrates that any acute haemoglobin reduction, even within the normal range, induces measurable heart rate changes that are directly related to probably the most optimal oxygen delivery state. Moreover, our studies show that wearable technology is sensitive enough to detect these effects. Hence, this nowadays readily available telemetry allows monitoring of subtle physiological changes in a research setting, but it also offers a path towards optimising QoL for patients with anaemia, polyglobulia and for blood donors.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"150-157"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145347522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of perioperative erythropoietin-stimulating agents and intravenous iron on patient outcomes following solid organ transplantation: A systematic review.","authors":"Frank Lee, Quentin Eichbaum, Christine Cserti-Gazdewich, Darren Mullane, Frederick W Lombard, Jeremy W Jacobs, Katerina Pavenski, Marina Englesakis, Alexander Dotto, Terry Cho, Andrés Leonard-Reixa, Jacqueline Trudeau, Andrew W Shih, Justyna Bartoszko","doi":"10.1111/tme.70045","DOIUrl":"10.1111/tme.70045","url":null,"abstract":"<p><p>Solid organ transplant is associated with high rates of anaemia and transfusion, but there is little comparative data on interventions such as erythropoietin-stimulating agents (ESAs) and intravenous (IV) iron. We conducted a systematic review examining the association of ESAs and IV iron with outcomes in adults undergoing solid organ transplant. This review was registered with PROSPERO (CRD42023474722). EMBASE and MEDLINE were searched from inception to April 11, 2025. Identified studies included adults (≥18 years of age) undergoing heart, liver, lung, or kidney transplant who received any ESA and/or IV iron before, during, or up to 1 month following solid organ transplant surgery compared to patients who did not. Article screening, full text review and data extraction were performed by two independent reviewers. The primary outcome of interest was transfusion volume, with secondary outcomes including haematological parameters, graft-related outcomes and rates of major morbidity and mortality. Results were analysed descriptively and compiled into tables, and the risk of bias was assessed using the CLARITY framework. From 1693 studies identified, 22 were included (kidney transplant, n = 16; heart transplant or Left Ventricular Assist Device as a bridge to transplant, n = 4; liver transplant, n = 2). Due to heterogeneity in design, interventions and outcomes, meta-analysis was not attempted. The quality of evidence was graded as Very Low. On the whole, a comprehensive strategy implementing ESAs and IV iron may improve haematological parameters and facilitate transfusion avoidance. High-quality prospective studies assessing the impact of protocols for haemoglobin optimisation and transfusion avoidance in solid organ transplant are needed.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"95-120"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145726392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective analysis of hypotension incidence and related factors during double filtration plasmapheresis (DFPP) in critically ill patients.","authors":"Xiulin Ye, Mengyuan Zhang, Hui Zhou, Lihua Qiu, Yuanyuan Yao","doi":"10.1111/tme.70054","DOIUrl":"10.1111/tme.70054","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the incidence and risk factors associated with hypotension in critically ill patients undergoing double filtration plasmapheresis (DFPP) to improve treatment safety and optimise haemodynamic management strategies.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on critically ill patients who underwent DFPP in the intensive care unit between April 2022 and April 2024. Patients were classified into hypotension and non-hypotension groups based on blood pressure changes following DFPP. Clinical data including APACHE II and SOFA scores, DFPP treatment parameters, blood access methods, anticoagulation strategies and vasopressor usage were compared between the groups. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors. Time to hypotension onset during DFPP was also analysed.</p><p><strong>Results: </strong>A total of 61 patients undergoing 190 DFPP sessions were included, with hypotension occurring in 86.8% of patients during one or more sessions. The APACHE II score was significantly higher in the hypotension group (p = 0.002). Logistic regression analysis identified systemic heparin anticoagulation (OR = 2.475, p = 0.013) and pre-existing vasopressor use (OR = 23.229, p = 0.002) as independent risk factors for hypotension. Additionally, single-needle blood access was associated with a higher incidence of hypotension (p = 0.023). Notably, 76.9% of hypotensive episodes occurred within the first 2 h of DFPP, with 41.7% occurring within the first hour.</p><p><strong>Conclusion: </strong>Systemic heparin anticoagulation and prior vasopressor use were significantly associated with an increased risk of hypotension during DFPP. These associations may reflect both treatment-related physiological effects and the intrinsic haemodynamic fragility of severely ill patients. Optimising vascular access, anticoagulation strategies and vasopressor management may help improve haemodynamic stability during DFPP, particularly in high-risk individuals. However, prospective studies are still needed to determine whether such adjustments can meaningfully reduce the incidence of DFPP-related hypotension.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"175-182"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145946402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions of donor screening-Do I always need to tell the truth?","authors":"Sheila F O'Brien, Lori Osmond, Mindy Goldman","doi":"10.1111/tme.70034","DOIUrl":"10.1111/tme.70034","url":null,"abstract":"<p><strong>Background: </strong>The Donor Health Assessment Questionnaire (DHQ) is fundamental to blood safety. We describe attitudes towards truthfulness among first-time donors who tested positive for transfusion transmissible infections and those who did not.</p><p><strong>Methods and materials: </strong>From 2005 to 2022 donors positive for infectious markers (cases) and demographically matched controls rated their agreement with statements about truthfulness, privacy and the value of the DHQ.</p><p><strong>Results: </strong>There were 798 (32% participation) cases and 3192 (39% participation) controls. Most said they read questions carefully (93% cases, 96% controls, p < 0.01) and answered truthfully (95% cases, 99% controls p < 0.01). Fewer thought the questions make the blood safer (79% cases, 80% controls, p = 0.39) and some agreed it is OK not to answer questions truthfully if you know your blood is safe (21% cases, 16% controls, p < 0.01). Privacy to answer personal questions was generally adequate (88% cases, 91% controls, p < 0.01). Attitudes were similar regardless of paper or electronic DHQ format.</p><p><strong>Conclusion: </strong>Most first time donors believe they answer screening questions truthfully, but some question the safety benefit to recipients and judge whether they need to be truthful. This was true for donors with positive infectious markers as well as their matched infection-negative controls.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"183-193"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145393090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a patient blood management programme for platelet therapy among haemato-oncology patients-A quasi-experimental study.","authors":"Vaidehi Prasanth, Daljit Kaur, Gita Negi, Gaurav Dhingra, Ashish Jain, Xavier Belsiyal, Chanchi B Khiamniungan","doi":"10.1111/tme.70016","DOIUrl":"10.1111/tme.70016","url":null,"abstract":"<p><strong>Background: </strong>The paucity of data pertaining to the implementation of the patient blood management (PBM) programme for platelet transfusion for improved patient outcomes with minimal risks motivated this study. The study aimed to implement an effective PBM programme for platelet transfusion therapy among haemato-oncology patients evaluating transfusion appropriateness and educational intervention for dedicated platelet transfusion practitioners (PtP).</p><p><strong>Study designs and methods: </strong>A quasi-experimental study was conducted for 1 year after Institutional ethics committee (IEC) (as shown in Annexure I) which included pre-intervention, intervention and post-intervention phases for four months each. The study involved platelet auditing, online survey questionnaires, educational intervention for the platelet transfusion practitioners (PtP) and feedback for user satisfaction.</p><p><strong>Results: </strong>The platelet audit showed statistically significant improvement (chi-square test, p < 0.05) in transfusion appropriateness, completeness of the forms filled, number of single donor apheresis procedures, ABO compatible transfusions and thereby reduction in platelet refractory cases during the post-intervention phase compared to the pre-intervention. The online survey showed improvement in self perceived knowledge and practice for all the stakeholders during the post-intervention period.</p><p><strong>Conclusion: </strong>The introduction of platelet transfusion practitioners and the educational sessions they underwent, had a significant impact in achieving transfusion appropriateness for platelet therapy and they gained the ability to prioritise medical emergencies, optimise platelet inventory management and minimise wastage. Educational interventions have enhanced practitioners knowledge and sensitised them to adhere to standard evidence-based platelet transfusion guidelines.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"165-174"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145178923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"All blood discard does not amount to blood wastage-A critical technical reappraisal.","authors":"Karan Kumar, Priyadarsini Jayachandran Arcot, Suchet Sachdev, Aarushi Sahni, Sangeeta Kumari, Ratti Ram Sharma","doi":"10.1111/tme.70031","DOIUrl":"10.1111/tme.70031","url":null,"abstract":"<p><strong>Background: </strong>Blood centres, as part of their routine operations, generate various forms of waste during the collection-to-transfusion continuum. However, not all discarded blood components equate to 'wastage'.</p><p><strong>Methods: </strong>A critical technical appraisal distinguishing blood discard (necessary and regulatory-compliant) from blood wastage (preventable and avoidable) was done.</p><p><strong>Results: </strong>We propose clear operational definitions and introduce refined metrics such as blood discard rate (BDR), blood wastage rate (BWR) and total discard rate (TDR) to ensure accurate reporting. The concept of 'all-cause blood discard' encompassing both justified discards and true wastage is emphasised.</p><p><strong>Conclusion: </strong>Misinterpretation of data on discarding as wastage by technical personnel, policymakers, media and the public at large can lead to a trust deficit in transfusion services. Adoption of these distinctions and metrics will improve transparency, resource management and public confidence in blood services.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"194-198"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Red blood cell ordering pattern following the introduction of a transfusion procedure based on haemoglobin concentration and anaemia symptoms: A retrospective study.","authors":"Julia Lipina, Piotr F Czempik","doi":"10.1111/tme.70019","DOIUrl":"10.1111/tme.70019","url":null,"abstract":"<p><strong>Introduction: </strong>Implementation of transfusion guidelines might be poor due to a lack of awareness and strong practice habits. The study aimed to evaluate the impact of a new guideline-based, locally adjusted transfusion procedure on physicians' ordering patterns in a large academic medical centre.</p><p><strong>Materials and methods: </strong>The study was a single-centre, retrospective study, analyzing period between January 2022 and December 2023. The study period was divided into three phases according to the procedure introduction: pre-introduction (January 2022-June 2022), introduction (July 2022-December 2022) and post-introduction (January 2023-December 2023, subdivided into 6-month periods). The new procedure was aimed at adult non-bleeding patients. Data on red blood cell (RBC) transfusions were obtained from a blood bank inventory and electronic health records. The appropriateness of transfusions was assessed against the newly introduced RBC procedure.</p><p><strong>Results: </strong>During the study period, 2413 out of 3686 (65.5%) RBCs were transfused for the indication of \"anaemia\". The number of transfused RBCs between 2022 and 2023 decreased by 467 (32.4%) units. The appropriateness of RBC transfusions increased from 53.6% in the pre-introduction phase to 79.1% by the end of the post-introduction phase. There was a decrease in median pre- and post-transfusion haemoglobin (Hb) concentration, from 73 (IQR 66-78) and 91 (IQR 80-99) to 67 (IQR 60-73) and 84 (IQR 75-93) g L^-1, respectively. The post-introduction phase showed sustained improvement in the appropriateness of RBC transfusions.</p><p><strong>Conclusions: </strong>The newly implemented RBC transfusion procedure, based on haemoglobin concentration and anaemia symptoms, supported by specific transfusion indications integrated into the computerised physician order entry system, resulted in a significant decrease in transfusions and an increase in appropriate transfusions. This improvement was sustained in the long term.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"133-141"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perinatal clinical management of a rare AB_h variant blood group.","authors":"Aritri Mandal, Laura Eastwood, Shane Grimsley, Louise Tilley, Clare Samuelson","doi":"10.1111/tme.70035","DOIUrl":"10.1111/tme.70035","url":null,"abstract":"<p><strong>Background: </strong>The H antigen, precursor of the A and B blood groups, is a high-prevalence antigen. Very few H antigen-negative (H-) blood donors are available in the United Kingdom.</p><p><strong>Case presentation: </strong>We present the case of a second pregnancy in a 28-year-old woman with the very rare AB_h phenotype, and the presence of anti-H, anti-A and anti-B. Only H- (O_h) and AB_h phenotype red cells were compatible. Given the rarity of individuals with these phenotypes, there were insufficient compatible red cell units for management of a major antepartum or postpartum haemorrhage. For this high-risk pregnancy, meticulous multidisciplinary team (MDT) planning took place between haematologists, obstetricians, anaesthetists, hospital laboratory staff and multiple teams within National Health Service Blood and Transplant including the National Frozen Blood Bank, Rare Donor Team and Red Cell Immunohaematology Laboratories. The MDT produced a birth management plan for various eventualities where blood transfusion may have been required. This process included the creation of our hospital's first vaginal cell salvage policy. A successful routine vaginal delivery was managed without transfusion.</p><p><strong>Conclusion: </strong>This case highlights the optimal care of a woman with an extremely rare blood group in pregnancy. The principles of management described here are also more widely applicable to women in whom transfusion is contraindicated, undeliverable or declined for other reasons.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"199-204"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145347471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}