The overall health of blood supply in countries with developed care systems is increasingly challenged by shifting use practices. For example, a decline in demand has occurred for red cells in general populations, but has been accompanied by a concomitant increase in demand for group O, Rhesus D negative [RhD–] blood for management of massive haemorrhage and other urgent transfusion scenarios. Moreover, newly identified infectious diseases pose a risk for transfusion-transmitted disease (eg, Zika virus), and the donor population is ageing.
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