Blood transfusion requirements and patient outcomes for Aboriginal and/or Torres Strait Islander peoples: are they different?

Abstract

Aboriginal and/or Torres Strait Islander (First Nations) peoples of the Northern Territory (NT) Australia attending for hospital care are higher risk compared to non-First Nations patients, with unmet healthcare needs relating to both anaemia and underling conditions associated with bleeding, such as trauma and haemorrhage during childbirth. In such settings, red cell (RC) transfusion may benefit First Nations patients. Blood transfusion may assist in offsetting adverse events associated with anaemia, and in emergency settings, can save lives. However, RC transfusion also carries some risk of harm. Recipients may develop alloantibodies to foreign antigens present in the blood donor but not the transfusion recipient. These alloantibodies can affect future pregnancies in women, and pose a higher risk of transfusion reactions in both men and women and delays in finding compatible blood for future blood transfusions, particularly in remote healthcare settings. This presentation will summarise RC transfusion experiences, use, outcomes, and risks of adverse transfusion reactions, including alloimmunisation, in First Nations peoples of the NT. This research aims to better inform clinical decision-making with First Nations patients potentially requiring transfusion. Moreover, blood has special cultural significance for many First Nations peoples, which must frame shared decision-making between RC transfusion prescribers and patients.