Parent perceptions of emergent blood transfusion in children

Abstract

AbstractBackgroundRhD‐negative blood products are in chronic short supply leading to renewed interest in utilizing RhD‐positive blood products for emergency transfusions. This study assessed parental perceptions of emergency RhD‐positive blood use in children.MethodsA survey of parents/guardians was conducted on their tolerance of transfusing RhD‐positive blood to RhD‐negative female children ≤17 years old at four level 1 pediatric hospitals.ResultsIn total, 621 parents/guardians were approached of whom 378/621 (61%) completed the survey in its entirety and were included in the analysis. Respondents were mostly females [295/378 (78%)], White [242/378 (64%)], had some college education [217/378 (57%)] and less than $60,000 annual income [193/378 (51%)]. Respondents had a total of 547 female children. Most children's ABO [320/547 (59%)] and RhD type [348/547 (64%)] were not known by their parents; of children with known RhD type, 58/186 (31%) were RhD‐negative. When the risk of harm to a future fetus was given as 0–6%, more than 80% of respondents indicated that they were likely to accept RhD‐positive blood transfusions on behalf of RhD‐negative female children in a life‐threatening situation. The rate of willingness to accept emergent RhD‐incompatible blood transfusions significantly increased as the potential survival benefit of the transfusion increased.ConclusionMost parents were willing to accept RhD‐positive blood products on behalf of RhD‐negative female children in an emergency situation. Further discussions and evidence‐based guidelines on transfusing RhD‐positive blood products to RhD‐unknown females in emergency settings are needed.