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14 October update on NHSBT's state of readiness for EU exit

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O D negative red cell toolkit

Information to help clinical and laboratory staff prevent wastage, and promote the safe and appropriate use, of O D negative red cells

Current demand

Total red cell usage is falling due to improved surgical techniques and the implementation of Patient Blood Management (PBM) initiatives including the use of alternatives. However, demand for O D negative is increasing. Stability of the supply chain for universal components such as O D negative red cells remains a challenge for most blood services around the world and we're working hard to ensure adequate supplies are available when required.

Efforts are primarily focused on improvement of donor marketing to achieve a blood group mix appropriate to clinical demands. Approximately 7% of the UK population is O D negative, but current (2019) average demand is greater than 12%.

We encourage you to make a difference and consider a range of initiatives to help conserve this precious resource.


NBTC recommendations on the appropriate use of O D negative red cells 2019 (JPAC website)

Survey of group O D negative red cell use 2018 

Maintaining supply and reducing wastage 

When is it safe to transfuse O D negative K positive and negative red cells


Good practice from Trusts

Experiences and initiatives on successfully managing stocks, wastage and appropriate use, for more information please contact the Trust. 

Guy's and St Thomas' NHS Foundation Trust 

St Georges' University Hospital

If you would like to share your Trust's good practice please contact your Patient Blood Management Practitioner or Customer Service Manager.


Designed for you to use alongside appropriate text in presentations and educational resources. Please acknowledge NHSBT as the author and please email our customer service team to let us know you've used them.

Consider using O D Pos for unknown males (PPT)

Consider using O D Pos – if >8 units O D Neg needed in females >50yrs with no anti-D antibodies and males with no anti-D antibodies (PPT)

Give group specific blood asap in an emergency (PPT)

Review O D neg stock levels to reduce wastage (PPT)

Stock sharing (PPT) 

Total RBC demand vs O D neg demand graph (PPT)

When to use O D neg – female under 50 years in an emergency (PPT)

When to use O D neg – O D neg patient with anti-D antibodies (PPT)


Blood Stocks Management Scheme

See the further resources section on the Publications page, for using the issuable stock index (ISI), and learning points on O D negative.