Last week nearly 14,000 donors received letters from us to let them know that they have an unusual subtype of blood called ‘Ro’. This generated a lot of interest and questions from our donors so I thought it might be worth a little discussion here.
What exactly is ‘Ro’?
It is a sub-type of the Rh blood group system. When you are given a blood group you first have the ABO group – that is either group A, B, AB or O, usually followed by a ‘+’ or ‘–‘. This relates to the Rh D group and whether it is present or not. In actual fact there are also other genes in the Rh group called C and E as well but we don’t need to match for these in most cases. We do however know the full Rh group for every unit of blood we collect and we give these a shorthand – one of which is ‘Ro’. Technically this is only half the sub-type but that’s probably enough information.
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Why do we need it?
Patients with sickle cell disease need blood that is more extensively matched than is required for other patients – this should include the full Rh type. Hospitals request blood with the full Rh type for these patients and we are only able to meet the exact specification for Ro about half of the time. This doesn’t harm patients as we are able to provide blood of another Rh type which also provides a full match. However this gives rise to two issues;
Firstly we like to give patients and hospitals what they ask for and we think we should be in a position to do this nearly all of the time. There are other potential benefits from doing this as we move forward with technology for matching blood.
Secondly when we don’t have a unit of Ro blood and we give a suitable alternative this is always a unit of Rh D negative blood. This puts even greater pressure on our O negative and B negative stocks – you may have noticed that we most often call donors with these groups. By managing our donations and stocks more effectively we hope that we will be able to reduce this pressure a little bit too.
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Who does it come from?
The Ro sub-type is relatively rarely seen in white ethnic donors but is really quite common in donors from black ethnic groups. However, of our Ro donors only 12% are from black ethnic backgrounds whereas 74% are white – this just demonstrates how many white donors we have compared with black donors on our donor base and why we need more of the latter.
We are also asking these donors, where possible, to donate blood on a Wednesday, Thursday or Friday, this is because these units are most commonly used for planned transfusions in patients needing regular blood.
In hospitals these patients have to have a recent blood sample (tested in the 3 days preceding each transfusion) which means in practice they are usually transfused on specific days of the week. Guidelines say that blood for these patients should be less than 14 days old and some hospitals like this blood to be less than 7 days old especially for some types of (exchange) transfusions. If donors donate on a Wednesday, Thursday or Friday then this tends to fit in best with the needs of the patients and hospitals. However, if this is not possible or convenient then, of course, your blood is welcome on what ever day you can donate and we thank you for doing this.