This has probably been rehashed a million times, but I haven't been to the site in awhile and wasn't able to pull up a thread on the topic. What is your policy about Rhogam injections or IV RhIG post infusion of Rh positive blood to an Rh negative woman of childbearing age or a female child? AABB does not commit on this subject, saying that IV RHIG is probably better than IM but "the use of either must be weighed against the risk of inducing clinically significant hemolysis..." We do give a rhogam injection to women post Rh positive platelets. If we have to give red cells I'm not sure what to recommend.

I like to repeat the story of an inadvertant Rh pos transfusion to an Rh neg young female patient. They sent the patient for a red cell exchange by pheresis, then did a Kleihauer and calculated the dose of RhIG based on residual Rh pos cells. It is such a novel approach I like to add it to people's lists of options.

then did a Kleihauer and calculated the dose of RhIG based on residual Rh pos cells.

Kleihauer/Betke does not detect Rh positive cells, it detects fetal cells and should not be used for this purpose.

I can see giving RhIG for Rh positive platelet transfusions, but for RBC transfusions, giving RhIG is probably an act in futility.

BTW, I heard insurance companies don't pay for RhIG given after Rh pos products (mentioned somewhere is this forum).

Good point. I must admit I am going from memory and didn't think that part through particularly. They might have estimated the residual from flow cytometry (D antigen) or even repeat fetal screens or just D typing.

It all depends on the amount of Rh Positive cells the receipient was exposed to. One dose should cover 30 ml or whole blood or 15 mls of packed RBC. Is it practical to give a women 15 shots of RhIg or give Winrho IV?