A study recently published in Transfusion found that a blood transfusion protocol used for patients with hemorrhagic shock in Los Angeles County may result in reduced mortality associated with hemolytic disease of the fetus and newborn (HDFN).
The protocol, known as the Los Angeles Development and Rapid Operationalization of Pre-Hospital Blood (LA-DROP), aims to quickly treat hemorrhagic shock before the patient arrives at the hospital. This is done via transfusion of low titer group O whole blood, which has low levels of anti-A and anti-B antibodies and contains platelets, plasma, and red blood cells.
RhD-positive blood is often used in individuals experiencing life-threatening bleeding events due to a lack of available RhD-negative blood. This poses a risk to RhD-negative females, as a transfusion of RhD-positive blood could lead to alloimmunization and HDFN in future pregnancies.
Using the program’s criteria, the retrospective study identified 743 individuals in Los Angeles who would have received a pre-hospital blood transfusion between November 1, 2021 and September 30, 2023. Of these patients, 739 experienced severe traumatic injury and 4 experienced postpartum hemorrhage.
Read more about HDFN causes and risk factors
The authors found that among all participants, the average risk of death due to HDFN was 1 death for every 10,000 transfusions. When limiting their analysis to only females of childbearing potential, the risk was 1 death per 1,800 transfusions.
Based on these values, the study estimated that the LA-DROP program would result in 1 death due to HDFN every 26 years.
“The estimated per-transfusion risk of HDFN is similar to previously published work from other populations,” the authors wrote. “The estimated frequency of deaths from HDFN associated with LA-DROP is lower than some previously published calculations, likely because of narrower eligibility criteria for transfusion.”
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