A practical strategy to reduce the risk of passive hemolysis by screening plateletpheresis donors for high-titer ABO antibodies.
BACKGROUND
Hemolytic transfusion reactions (HTRs) can occur from ABO-incompatible platelet (PLT) transfusions. After a series of cases at our institution, a procedure to screen all plateletpheresis donors for high-titer ABO antibodies was implemented.


METHODS
Plasma samples from plateletpheresis donors were screened using pooled 0.8% A1 and 0.8% B red blood cells (RBCs) in buffered gel. Dilutions of 1 in 150, 1 in 200, and 1 in 250 were sequentially evaluated. A component testing positive for high-titer ABO antibodies was restricted to ABO-identical or group O recipients or washed.


RESULTS
At the initial dilution of 1 in 150, half of group O components were labeled as high titer. At the current dilution of 1 in 250, 25% of group O components are labeled as high titer. No PLT-associated HTR has been reported since screening began.


CONCLUSIONS
Universal screening for high-titer ABO antibodies in plateletpheresis donors can be implemented efficiently to reduce the risk of HTRs. The cutoff for classifying a unit as high titer depends on the serologic method used and may be customized by the individual facility. Our screening method uses one gel test per donation regardless of blood group and a plasma dilution of 1 in 250 with pooled A1/B RBCs in buffered gel.
Quillen
Karen
K
Department of Transfusion Medicine, NIH Clinical Center, Bethesda, Maryland, USA. kq@bu.edu
Sheldon
Sherry L
SL
Daniel-Johnson
Jennifer A
JA
Lee-Stroka
A Hallie
AH
Flegel
Willy A
WA
D000017:ABO Blood-Group System / Q000276:immunology*; D000906:Antibodies / Q000276:immunology*; D001787:Blood Group Incompatibility / Q000175:diagnosis* / Q000276:immunology*; D046148:Donor Selection / Q000379:methods*; D004912:Erythrocytes / Q000276:immunology; D006461:Hemolysis; D006801:Humans; D010983:Plateletpheresis
D000017:ABO Blood-Group System; D000906:Antibodies