Safety measures to prevent ABO-incompatible red blood cell (RBC) transfusions are in place throughout the entire process from blood donation to the recipients’ bedsides, though practices vary between countries and facilities. Preventive safety measures have reduced ABO-incompatible transfusions to less than one in 100,000 transfusions. Researchers in Europe explored the causes and frequencies of ABO-incompatible RBC transfusions in France, Germany, and the United Kingdom from 2013 to 2022. While all three countries had enacted similar safety precautions, Germany had a higher frequency of ABO-incompatible RBC transfusions (0.71 per 100,000 transfusions) compared to France (0.19 per 100,000) and the U.K. (0.28 per 100,000). ABO-incompatible transfusions usually involved transfusion of a group A unit to a group O patient (France, 72%; Germany, 62%, and U.K., 50%); overall mortality from serious adverse reactions was 5% of ABO-incompatible transfusions. ABO-incompatible transfusions were usually caused by incorrectly performed patient identification checks or bedside ABO compatibility tests. Bedside ABO compatibility testing was not found to be beneficial in reducing incompatible transfusions; however, both electronic patient identification and national bedside patient guidelines may be helpful. Further reductions in ABO-incompatible RBC transfusions are needed.
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