Immunologic risks of whole blood: ABO compatibility, D alloimmunization, and transfusion‐related acute lung injury

Harm, Sarah; Dunbar, Nancy M.

doi:10.1111/trf.15168

Cited by 9 publications

(4 citation statements)

References 29 publications

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“…To address this issue, a minor crossmatch can be performed, in which donor plasma is mixed with recipient RBCs. Although conflicting data and practices exist ( Fung et al., 2007 ; Lozano and Cid, 2003 ), detection of high anti-ABO(H) antibody levels in whole blood, platelet, and plasma donor units may reduce ABO(H)-related complications ( Dunbar et al., 2015 ; Harm and Dunbar, 2019 ; Josephson et al., 2004 , 2010 ; Simmons and Savage, 2015 ; Strandenes et al., 2014 ). Alternatively, some studies suggest that washing blood products prior to ABO(H) discrepant transfusions can improve outcomes ( Blumberg et al., 2018 ; Refaai et al., 2018 ; Sahai et al., 2017 ).…”

Section: Abo Blood Group Systemmentioning

confidence: 99%

ABO blood group antigens and differential glycan expression: Perspective on the evolution of common human enzyme deficiencies

Jajosky

Zheng

et al. 2023

iScience

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Section: Abo Blood Group Systemmentioning

confidence: 99%

ABO blood group antigens and differential glycan expression: Perspective on the evolution of common human enzyme deficiencies

Jajosky

Zheng

et al. 2023

iScience

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“…Each unit of CT pRBC contains less than 10 mL of plasma and as such, type O pRBC can be used for transfusion regardless of ABO blood group of the recipient. Traditionally, CT with FFP and platelets need to be ABO compatible due to the risk of transfusion-related immunological reactions [9]. WB contains plasma and as discussed previously; the amount is almost equal to the amount contained in a traditional unit of FFP.…”

Section: Component Therapy (675 Ml)mentioning

confidence: 99%

“…Despite this fact, there is significant evidence that demonstrates that this is not the case, and that the risk of intravascular hemolysis is not any different or even any higher than with CT. Currently, most centers use LTOWB with low levels of anti-A and anti-B IgM defined as a titer of less than 1:256, although there is no definition of a volume of incompatible plasma that can be safely used without consequence of hemolysis [9]. In fact, there is evidence that transfusion with WB with anti-A and anti-B titers as high as 400 was not related to major transfusion-related reactions [10].…”

Section: Component Therapy (675 Ml)mentioning

confidence: 99%

The Use of Whole Blood Transfusion in Trauma

Hanna

Knittel

Gillihan

2022

Curr Anesthesiol Rep

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Purpose of Review This review illustrates the current benefits, limitations, ongoing research, and future paths for Low Titer O Whole Blood compared to Component Therapy in massive transfusion for trauma patients. Recent Findings Many studies show that compared to Component Therapy, Low Titer O Whole Blood transfusion is associated with better patient outcomes and simplified transfusion logistics among others. There are, however, issues with cost, supply/demand and handling of Whole Blood that limit its use, but experience in the military setting has shown that these limitations can be easily overcome. Summary The use of Whole Blood has increased in the civilian trauma population and there is a growing body of evidence to support its current use. More research looking at Whole Blood in females of child-bearing age, pediatric populations, and cold-stored platelets is underway.

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“…Most recently, fresh WB transfusion resurged during the wars in Iraq and Afghanistan [5,6,7] followed by adoption in civilian medical centers across the United States [8]. Despite the resurgence of WB mostly in the military setting, safety concerns exist including a potential increased risk of ABO incompatibility during emergent resuscitation, transfusion-associated hemolysis, and the risk of Rh alloimmunization, especially in women of childbearing age [9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Cold whole blood transfusion in civilian trauma patients requiring emergent resuscitation: a retrospective cohort study

Fischmann

Bryant

Zielinski

et al. 2022

Preprint

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Background: The use of cold whole blood (WB) is rapidly resurging as one of the treatment modalities of choice for the initial resuscitation of civilian trauma patients across the United States. The purpose of our study was to evaluate the effectiveness and safety of cold whole blood (WB) as compared to blood component therapy (BCT) in resuscitation of civilian trauma patients. Methods: This was a retrospective cohort study of trauma patients who received at least one unit of WB transfusion during emergent resuscitation between November 2015 and October 2019 at a level I trauma center. Primary outcome was mortality up to 30 days after trauma. Secondary outcomes included overall blood product utilization and incidence of transfusion reactions. Outcomes were compared between patients who received WB and a cohort receiving BCT who did not receive WB matched for age, sex, mechanism of injury, heart rate, systolic blood pressure, Glasgow Coma Scale, injury severity score, and FAST results. Results: We included 78 patients who received WB transfusion and 78 matched controls. Within 30 days of injury, there were 19 deaths (24.4%) in the WB cohort and 28 (35.9%) deaths in controls (hazard ratio 0.62, 95% CI 0.33 to 1.15, p = 0.086). Patients in the WB cohort received as many units of blood products as controls (median number of units was 10 (IQR 6, 20) vs. 12 (IQR 6, 23), p = 0.43). The incidence of any transfusion reactions was similar between groups (7.7% in WB vs 9.0% in controls, p = 0.78). Life-threatening reactions did not occur in any of the groups. Conclusions: There was no mortality difference between patients receiving cold WB and BCT. Cold WB was safe in this cohort with no life-threatening transfusion reactions.

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Immunologic risks of whole blood: ABO compatibility, D alloimmunization, and transfusion‐related acute lung injury

Cited by 9 publications

References 29 publications

ABO blood group antigens and differential glycan expression: Perspective on the evolution of common human enzyme deficiencies

ABO blood group antigens and differential glycan expression: Perspective on the evolution of common human enzyme deficiencies

The Use of Whole Blood Transfusion in Trauma

Cold whole blood transfusion in civilian trauma patients requiring emergent resuscitation: a retrospective cohort study

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