Hyperbilirubinemia Due to Exchange Transfusion in the Newborn

Group O blood is commonly used for exchange transfusion in hemolytic disease of the newborn regardless of the blood group of the baby. The anti-A and anti-B isoagglutinins of the Group O donor blood cause hemolysis of the infant's remaining A or B cells. The resulting hyperbilirubinemia necessitates multiple transfusions. This can occur even with the use of a "nondangerous Group O donor" and AB substance. The authors recommend that in Rh hemolytic disease group-specific blood always be used. In ABO hemolytic disease they recommend using Group O blood, removing the plasma, and resuspending the Group O cells in compatible plasma for exchange transfusion in A or B babies. Group-specific (AB) substance added to Group O blood is dangerous.