Practices associated with ABO-incompatible platelet transfusions: a BEST Collaborative international survey.
BACKGROUND
There is a lack of evidence for guiding the best strategy for ABO selection of platelet (PLT) transfusions. As a baseline for future studies, the BEST Collaborative performed an international survey of current practices in this area.


METHODS
An international survey was sent via BEST members to transfusion services and hospitals requesting the demographics of the transfused patient population, ABO matching policies, anti-A and anti-B measurements in PLT concentrates (PCs), and practices regarding ABO-incompatible PC transfusions to adult and pediatric patients.


RESULTS
We received 126 responses from 14 countries, 59% from Europe. Most of them were from local/community (42%) and university hospitals (39%) serving between 500 and 1500 beds; 50.4% transfused fewer than 1000 PCs per year. One-fifth of respondents (19.4%, mainly local/community hospitals) did not have a written policy for selecting ABO-incompatible PCs. Significant practice variation was reported when ABO-mismatched PLTs were given to adults: for PCs suspended in 100% plasma, 29% to 43% of respondents selected any ABO group available; 52% to 61% selected units with compatible supernatant; and, in the case of minor ABO incompatibility, 43% to 54% did not take any specific action. In contrast if ABO-identical PCs were not available for a pediatric recipient, for PCs resuspended in 100% plasma, 71% to 82% selected PCs so the supernatant plasma would be compatible with patient's red blood cells.


CONCLUSIONS
Considerable practice variation exists when transfusing ABO-incompatible PCs, suggesting an opportunity for research to inform evidence-based practices.
Lozano
Miguel
M
Department of Hemotherapy and Hemostasis, Hospital Clinic, IDIBAPS, Barcelona, Spain. mlozano@clinic.ub.es
Heddle
Nancy
N
Williamson
Lorna M
LM
Wang
Grace
G
AuBuchon
James P
JP
Dumont
Larry J
LJ
D000017:ABO Blood-Group System / Q000276:immunology*; D000328:Adult; D001787:Blood Group Incompatibility / Q000628:therapy*; D003299:Cooperative Behavior; D006801:Humans; D017713:Platelet Transfusion
D000017:ABO Blood-Group System