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Statement: NHS Blood and Transplant explains recent communication to Ro donors

26 November 2014

We recently wrote to some of our donors who we have identified as having an Ro subtype of their Rhesus blood group, to explain that, wherever practical to do so, we would prefer them to donate on a Wednesday, Thursday or Friday.

Many of the donors we wrote to, had not heard of the Ro subtype before, and therefore did not know what being Ro means nor why their blood is particularly important to us. We apologise for any confusion caused.

When you donate blood we let you know what blood type you are (A+, A-, B+, B-, AB+, AB-, O+ or O-) soon after your first donation. We do not routinely tell donors their Rh subtypes unless there is a reason for asking them to donate more regularly or at particular times.

The information below helps explain what the Ro subtype is. We hope this answers any questions you have.

Many thanks for saving lives.

What does Ro mean?

Ro is a sub type of your Rhesus blood group. Part of the Rh blood group (the D gene) is what gives you the positive (+) or negative (-) after the letter A, B, AB or O. The Rh blood group system has two Rh genes (D and CE). CE produces 4 combinations: ce, Ce, cE or CE. The combination of cDe is referred to as Ro. This doesn't affect your main blood group. So you might be B+ positive, but the positive (+) is part of the fuller type which might be Ro.

All ABO groups can be Ro as it is the sub type of your Rhesus blood group, this also gives you the positive or negative after the letter A,B,AB or O.

Why are Ro donors needed?

Ro blood is needed for certain patients who also have Ro blood. Often these patients are the ones who require ongoing blood transfusions so it's very important we collect enough of it. However, only a very small percentage of our donors have Ro blood, which is why we recently contacted Ro donors to let them know they are one of them. While Ro blood group is rare among white ethnic donors, it is much more common in Black African and African Caribbean people, which is one reason why we ask more of them to come forward to donate.

Is the Ro phenotype mostly found in the black community?

The Ro phenotype is over 10 times as common in individuals from Black backgrounds compared to individuals from White backgrounds and is very common in patients with sickle cell disease. However we are asking both white and black donors with this subtype to understand that they have an blood subtype that is not common in our donor base and one that we need more of. This fact that Ro donors are much more commonly found in Black populations is one of the reasons why we are asking many more Black Asian and Minority Ethnic donors to donate blood.

Why are you asking Ro donors to donate on a Wednesday, Thursday or Friday

Many of the treatments that use Ro bloods, for conditions such as Sickle Cell disease, take place on specific days of the week, so we need to collect the Ro blood to fit in with the needs of patients. Also, hospitals require the Ro donations for sickle cell patients to be less than 7 days old. As most routine sickle cell transfusions are carried out on specific days there is a very limited window when Ro donations are suitable for use. That is why we are asking Ro donors to give on a Wednesday, Thursday and Friday where possible.

What if I can't donate on a Wednesday, Thursday or Friday?

We appreciate that it may not always be convenient for you to donate on a Wednesday, Thursday or Friday and that we may not hold sessions in your area on those days of the week.

If you are an Ro donor and giving blood on a Wednesday, Thursday or Friday isn't feasible - don't worry. Please continue donating as the blood you give will always be used to help save and improve patients’ lives.

What is Sickle Cell Disease?

Sickle cell disease is an inherited disorder of haemoglobin. Individuals with Sickle Cell disease have abnormal, or ‘sickle shaped’ red cells which last in the circulation for less time than usual as a result these patients become anaemic and they require ongoing blood transfusions for life.

Are people with Ro immune or less likely to get chronic conditions such as Sickle Cell Disease?

Sickle cell disease is inherited in the same way that hair or eye colour are. Sickle Cell Disease is more prevalent within the black community and Ro is more prevalent within the black community but the two factors are not codependent. Thus Ro has no impact on whether you have Sickle Cell or vice versa – it just happens that both are more common within the Black Community.

If I have Ro blood does this mean I can only receive Ro blood if I need it in the future?

No, Ro recipients have RhD + blood and the vast majority of people receiving transfusions can simply receive RhD + blood of a compatible ABO group. If patients need more specifically (extended) matched blood then they can receive Ro blood or a subtype of RhD negative blood safely.

What is O RhD negative?

O RhD negative (known commonly as O negative), is very special indeed. It is called the universal donation and can be given to anyone. When Ro blood is not available for Ro patients, this is what is given. Equally O negative is the only safe option when a patient's blood group is unknown or not immediately available - such as in emergencies, or in the case of specialised procedures for unborn babies.