title: How do I implement an automated screen for high-titer ABO antibody as an inventory management tool for ABO plasma-incompatible platelets?
abstract: BACKGROUND
  Plasma volume reduction (PVR) may reduce the risk of hemolysis associated with transfusion of plateletpheresis blood products (PLTs) containing ABO-incompatible plasma. But PVR may delay PLT issue. In collaboration with our blood donor center we evaluated an automated screen of PLT for high-titer ABO antibody and to apply PVR to high-titer PLTs.
  
  
  METHODS
  At the donor center, plasma from PLT donors was tested using an automated microplate system (PK7300, Beckman). PK settings were set for a detection cutoff equivalent to 1 in 256 using a manual tube method. The donors associated with high-titer PLTs were characterized by sex and age. In the transfusion service, the number of PVR procedures was evaluated before and after implementation of the high-titer screen.
  
  
  RESULTS
  During validation, 157 of 1008 PLT units (15%) were positive by the automated method versus 121 (12%) by manual method. After implementation, 2112 of 15,240 PLT units were high-titer, with higher frequency in donations from females versus males (18% vs. 12%, p < 0.0001). The PLT PVR rate was reduced by 50%.
  
  
  CONCLUSIONS
  Implementation of an automated method to screen PLTs for high-titer ABO antibody at the donor center improves the inventory management of PLTs containing ABO-incompatible plasma at the hospital transfusion service.
authors.affiliation: Department of Pathology, University of Maryland Baltimore, Baltimore, Maryland.
authors.forename: Magali J
authors.initials: MJ
authors.lastname: Fontaine
authors.affiliation: Department of Pathology, Stanford University, Stanford, California.
authors.forename: Jan
authors.initials: J
authors.lastname: Webster
authors.affiliation: Department of Pathology, Stanford University, Stanford, California.
authors.forename: Samantha
authors.initials: S
authors.lastname: Gomez
authors.affiliation: Department of Pathology, Stanford University, Stanford, California.
authors.forename: Tho D
authors.initials: TD
authors.lastname: Pham
authors.affiliation: Department of Pathology, Stanford University, Stanford, California.|Department of Medicine, Stanford University, Stanford, California.
authors.forename: Lawrence T
authors.initials: LT
authors.lastname: Goodnough
authors.affiliation: Department of Pathology, Stanford University, Stanford, California.
authors.forename: Susan A
authors.initials: SA
authors.lastname: Galel
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology*; D000328:Adult; D000368:Aged; D001787:Blood Group Incompatibility / Q000175:diagnosis*; D001792:Blood Platelets / Q000276:immunology*; D005260:Female; D006801:Humans; D007518:Isoantibodies / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010953:Plasma Volume
chemical_list: D000017:ABO Blood-Group System; D007518:Isoantibodies