Association Bulletin #24-02 Focuses on Considerations for RhIG Shortages

AABB released Association Bulletin (AB) #24-02 on Monday, which provides information and resources to inform clinical practice decisions and inventory management strategies during unexpected and/or prolonged shortages of Rho(D) immune globulin (RhIG).

In December, the Food and Drug Administration reported a shortage of RhIG caused by issues in the anti-D plasma market and manufacturing deviations. While the shortage initially affected one U.S. manufacturer, it has now expanded to include other RhIG manufacturers.

Developed by an ad hoc working group of AABB member physicians, AB #24-02 summarizes the typical use of RhIG and provides approaches facilities may consider during supply shortages. It includes the following key considerations:

• Transfusion medicine professionals, in collaboration with other local stakeholders, should consider developing institutional policies for RhIG use.
• Institutional stakeholders should regularly monitor RhIG inventory and establish policies and procedures for RhIG allocation during various levels of inventory shortages to ensure and prioritize RhIG availability to pregnant D-negative patients whenever possible.
• Transfusion services should have policies for the appropriate use of RhIG prophylaxis for D-negative patients of child-bearing potential who have been exposed to D-positive red blood cells (RBCs) per AABB’s Standards for Blood Banks and Transfusion Services.

AB #24-02 also contains considerations for D-negative recipients of D-positive hematopoietic progenitor cell products and for patients with immune thrombocytopenia.

Members should note that this bulletin does not contain specific recommendations, nor does it create a standard or accreditation requirement. AABB members may access all active Association Bulletins on the AABB website.