Anti‐A and anti‐B titers in pooled group O platelets are comparable to apheresis platelets

Cooling, Laura; Downs, Theresa; Butch, Suzanne H.; Davenport, Robertson D.

doi:10.1111/j.1537-2995.2008.01814.x

Cited by 61 publications

(73 citation statements)

References 29 publications

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“…Had ‘high titer' been defined in this study as ≥256, 26% of group O apheresis PLTs would have been labeled as such which is similar to the 39% of ‘high titer' group O apheresis PLTs described above [3]. Using an IgG titer of ≥64, approximately half of the group O apheresis PLTs in this study [5] would have been labeled ‘high titer', a figure that is similar to a previous report of the prevalence of ‘high titer' pooled group O PLT units [4]. In contrast, Quillen et al [6] found that half of their group O apheresis PLTs would have been considered ‘high titer' at a screening dilution of 1:150, while 25% of these donations are handled as ‘high titer' PLTs with their current threshold of 1:250.…”

Section: Part 1: Plt Transfusion and Abo Compatibilitysupporting

confidence: 68%

“…Another study revealed that 60% of group O pooled PLT units, which consisted of 4-5 individual units, harbored an anti-A and/or anti-B titer of ≥64 by the gel technique [4]. Using this technique, the mean anti-A titer was 64 and the mean anti-B titer was 32.…”

Section: Part 1: Plt Transfusion and Abo Compatibilitymentioning

confidence: 99%

“…In one study, it was demonstrated that including 1 non-group O whole blood-derived PLT unit in a pool of 3-4 group O PLTs decreased the titer of, or outright neutralized, the anti-A and anti-B antibodies in the pool [4]. This practice of adding a non-group O whole blood PLT unit in order to decrease the anti-A or anti-B titer should be used with caution as there is a potential for the formation of immune complexes, PLT activation, and an increase in PLT microaggregates which, in small studies, have been implicated in causing adverse clinical outcomes (discussed in more detail below) [26,27].…”

Section: Part 1: Plt Transfusion and Abo Compatibilitymentioning

confidence: 99%

See 2 more Smart Citations

Platelet Transfusion - the Art and Science of Compromise

Cid

Harm

Yazer

2013

Transfus Med Hemother

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Many modern therapies depend on platelet (PLT) transfusion support. PLTs have a 4- to 7-day shelf life and are frequently in short supply. In order to optimize the inventory PLTs are often transfused to adults without regard for ABO compatibility. Hemolytic reactions are infrequent despite the presence of ‘high titer' anti-A and anti-B antibodies in some of the units. Despite the low risk for hemolysis, some centers provide only ABO identical PLTs to their recipients; this practice might have other beneficial outcomes that remain to be proven. Strategies to mitigate the risk of hemolysis and the clinical and laboratory outcomes following ABO-matched and mismatched transfusions will be discussed. Although the PLTs themselves do not carry the D antigen, a small number of RBCs are also transfused with every PLT dose. The quantity of RBCs varies by the type of PLT preparation, and even a small quantity of D+ RBCs can alloimmunize a susceptible D- host. Thus PLT units are labeled as D+/-, and most transfusion services try to prevent the transfusion of D+ PLTs to D- females of childbearing age. A similar policy for patients with hematological diseases is controversial, and the elements and mechanisms of anti-D alloimmunization will be discussed.

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Section: Part 1: Plt Transfusion and Abo Compatibilitysupporting

confidence: 68%

Section: Part 1: Plt Transfusion and Abo Compatibilitymentioning

confidence: 99%

Section: Part 1: Plt Transfusion and Abo Compatibilitymentioning

confidence: 99%

See 1 more Smart Citation

Platelet Transfusion - the Art and Science of Compromise

Cid

Harm

Yazer

2013

Transfus Med Hemother

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“…Also, a small number of institutions prospectively screen group O single donor apheresis PTLs for the presence of high titer agglutinins. (5) Similarly, there is a shortage of identical organ and blood donors. Both situations need blood bank strategies to minimize the biological effects of ABO antibodies.…”

Section: Introductionmentioning

confidence: 99%

Titers of ABO antibodies in group O blood donors

França¹,

Poli²,

Ramos³

et al. 2011

Rev. Bras. Hematol. Hemoter.

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BackgroundPlasma components of group O blood donations are rarely submitted to ABO antibody titrations even though it is well known that passively acquired antibodies may destroy the recipient's own red cells and tissue grafts.ObjectiveThus, group O donations stratified by gender and age were randomly titrated to identify the best source of products for apheresis and exsanguinous transfusion.MethodsSamples from 603 blood donors were tested by ABO antibody titration using the conventional tube technique at room temperature. ABO antibody levels higher than 64 were considered high. After correction for gender, statistical analyses were performed using the Fisher exact and Kruskal-Wallis tests.ResultsMost donors in the blood bank were male (65.7%). ABO antibody titers ranged from 1 to 2048. The estimations of prevalence for the titers were: anti-A,B < 128 = 86.9% and = 128 = 2.16%; Anti-A = 128 = 9.29% and anti-B = 128 = 4.81%. Low mean titers for both anti-A and anti-B antibodies were found in over 50-year-old men (p-value = 0.040). High anti-B antibody levels were found in young women (p-value = 0.002).ConclusionThis study confirms that over 50-year-old O group men should be selected as blood donors in non-identical ABO transfusion situations. Also, titration of ABO antibodies in blood banks will increase safety in non-identical ABO transfusions.

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“…Screening donors for a predefined high titered anti-A/ anti-B likely reduces the incidence, but to date, there is no consensus on immunoglobulin class or what level constitutes a critical titer. 6,[35][36][37] Volume reduction or replacing the plasma with saline may mitigate such minor ABO-mismatched hemolysis but compromise platelet integrity and function. 38 Our work suggests that it is prudent to investigate a clinically significant drop in hemoglobin for minor ABO-mismatched recipients of minor ABO-mismatched products who may have a hematologic myelopathy.…”

Section: Discussionmentioning

confidence: 99%

Potential impact of complement regulator deficiencies on hemolytic reactions due to minor ABO-mismatched transfusions

et al. 2017

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Key Points• An in vitro model shows that hemolysis could be due to the presence of a subclinical PNH clone causing a negative C3b/d DAT.• Changes to decayaccelerating factor and membrane inhibitor of reactive lysis may lead to overt hemolysis after minor mismatched transfusions.Minor ABO-mismatched transfusions are a common occurrence, although infrequent transfusion reactions occur. We sought to investigate the regulation of complement

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Anti‐A and anti‐B titers in pooled group O platelets are comparable to apheresis platelets

Abstract: Anti-A and anti-B titers in group O PPLTs are comparable to those reported in group O SDPs and significantly lower than titers reported in AHTR. A critical direct agglutinin titer of 64 for identifying high-titer units by gel is too low and should be increased to 128 or higher.

Cited by 61 publications

References 29 publications

Platelet Transfusion - the Art and Science of Compromise

Platelet Transfusion - the Art and Science of Compromise

Titers of ABO antibodies in group O blood donors

Potential impact of complement regulator deficiencies on hemolytic reactions due to minor ABO-mismatched transfusions

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