Rh Blood Type Compatibility and Transfusion Guidelines

Introduction to Rh Compatibility

• The American College of Obstetricians and Gynecologists recommends that all female children and women of childbearing potential receive Rh-negative blood when they are Rh-negative themselves to prevent future hemolytic disease of the fetus and newborn (HDFN) 1, 2

Special Populations Requiring Rh-Negative Blood

• Patients with sickle cell disease should receive Rh-negative blood when they are Rh-negative themselves, as they require extended antigen matching beyond just ABO/RhD to prevent alloimmunization 3, 4, 5
• The American Society of Hematology recommends that patients receiving multiple transfusions receive Rh-negative blood when they are Rh-negative themselves, as alloimmunization prevention is critical in this population 6, 7

Management of Rh Incompatibility

• The American College of Obstetricians and Gynecologists recommends administering anti-D immunoglobulin (RhIG) within 72 hours after an Rh-negative patient inadvertently receives Rh-positive blood, with a dosing of 20-25 mg (100-125 IU) of RhIG protecting against 1 mL of RBCs 2, 8