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AABB Issues Recommendations to Decrease Group O Blood Overuse

  • July 1, 2019
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June 27, 2019

Contact: AABB Communications 
Magda Yang 

AABB Issues Recommendations to Decrease Group O Blood Overuse

Association encourages blood banks and hospitals to work together to optimize group O blood use.

Bethesda, Md. – In response to ongoing blood shortages in many regions of the United States, AABB (formerly known as the American Association of Blood Banks) this week released a series of recommendations to help blood collection facilities and hospitals decrease the overuse of group O blood. Known as “universal donors” since their blood can be transfused to any patient, individuals with group O-negative blood comprise nearly seven percent of the blood donor population but use of O-negative red blood cells accounts for nearly 11 percent of all transfused red blood cells — an unsustainable ratio that continues to threaten the stability of the nation’s blood supply.

The AABB Association Bulletin’s recommendations are particularly important as many regions in the United States are experiencing a blood shortage this summer. AABB believes that adhering to these recommendations will alleviate some of the potential consequences of the blood shortage and help to ensure blood is available for all patients when it is needed.

“Overreliance on group O blood places an unnecessary burden on both blood collectors and hospital transfusion services,” said AABB President Michael M. Murphy, MD, FRCP, FRCPath, FFPath. “These practical recommendations will help alleviate the pressure on this precious resource and assist facilities to conserve it for when it is absolutely necessary.”

Group O red blood cells (RBCs) are appropriately transfused in several settings, including the initial resuscitation of trauma patients with unknown blood type. However, there are many situations in which their use is not imperative. AABB’s Bulletin includes the following recommendations and encourages blood centers to work with hospitals to develop ways to adopt them:

  1. Group O-negative RBCs should be reserved for three cohorts of women of childbearing potential: those who are group O-negative, those who are Rh(D)- requiring transfusion when type specific blood is unavailable, and those with unknown blood type who require RBCs before the completion of pretransfusion testing.
  1. Hospital transfusion services should closely monitor utilization of group O-negative inventory, particularly during bleeding emergencies and during group O Rh(D)- shortages. Policies should specify when patients should be switched to Rh(D)+ RBCs to avoid depletion of the group O Rh(D)- supply.
  1. Hospitals should have protocols to expedite sample collection to quickly switch patients to type specific blood upon completion of pre-transfusion testing.

A list of recommendations and the reasoning behind those guidelines is available in the Bulletin. Additional questions should be sent to

About AABB
AABB is an international, not-for-profit association representing individuals and institutions involved in the fields of transfusion medicine and cellular therapies. The association is committed to improving health through the development and delivery of standards, accreditation and educational programs that focus on optimizing patient and donor care and safety. AABB membership includes physicians, nurses, scientists, researchers, administrators, medical technologists and other health care providers. AABB members are located in more than 80 countries and AABB accredits institutions in more than 50 countries.

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