Giving Rhogam (Rh Immunoglobulin) To A Man?

Rhogam is for women, right? The ATLS course points out that pregnant women who are Rh- and sustain significant blunt torso trauma should empirically receive Rhogam in case the fetus turns out to be Rh+.

But there is one situation where men might receive it. Most trauma centers use O- blood as their universal donor units because it does not contain any major antigens. However, O- blood is uncommon. Worldwide, only 4-9% of the population have this blood type. In China, the incidence of O- blood is nearly zero! So busy centers that don’t have much O- may substitute O+ blood for men. They then switch to the proper blood type when the crossmatch is complete

This makes sense, since men don’t ever have to worry about a Rh+ fetus. However, since this typically occurs at very busy (read: high penetrating injury) centers, there is a significant number of repeat offenders. And if they receive it again, the antibodies to the Rh factor they developed the first time can cause a significant hemolytic reaction. So men who receive O+ blood must be typed and given Rhogam if they are Rh-.

Reference: Emergency uncrossmatched transfusion effect on blood type alloantibodies. J Trauma 72(1):48-53, 2012.

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