title: Survival Time of Cross-Match Incompatible Red Blood Cells in Adult Horses.
abstract: BACKGROUND
  There is a markedly reduced half-life of transfused RBCs when donor and recipient cats or humans are cross-match incompatible. Only 10-20% of horses have naturally occurring alloantibodies. Therefore, cross-match testing before blood transfusion is not always performed.
  
  
  OBJECTIVE
  Cross-match incompatibility predicts shortened RBC survival time as compared to that of compatible or autologous blood.
  
  
  METHODS
  Twenty healthy adult horses.
  
  
  METHODS
  Prospective trial. Blood type, anti-RBC antibody screen (before and 1 month after transfusion) and major and minor cross-match determined 10 donor-recipient pairs. Two pairs were cross-match compatible, the remainder incompatible. Donor blood (4 L) was collected into citrate phosphate dextrose adenine-1, labeled with NHS-biotin, and transfused into recipients. Samples were collected at 1 hour and 1, 2, 3, 5, 7, 14, 21, 28, and 35 days after transfusion, and biotinylated RBCs were detected by flow cytometry. Horses were monitored for transfusion reaction during transfusion and daily for 5 days.
  
  
  RESULTS
  Cross-match incompatibility was significantly associated with decreased RBC survival time (P < .001). The half-life of transfused incompatible (cross-match >1+) allogenic equine RBCs was 4.7 (95% CI, 3.2-6.2) days versus 33.5 (24-43) days for compatible pairings. Cross-match incompatibility was associated with acute febrile transfusion reaction (P = .0083). At day 30, only 1 horse had developed novel anti-RBC antibodies.
  
  
  CONCLUSIONS
  Cross-match incompatibility was predictive of febrile transfusion reaction and shortened transfused RBC survival, but did not result in production of anti-RBC antibodies at 30 days. Cross-match testing before transfusion is recommended.
authors.affiliation: Department of Clinical Studies - New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, PA.|Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY.
authors.forename: J E
authors.initials: JE
authors.lastname: Tomlinson
authors.affiliation: Department of Clinical Studies - New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, PA.
authors.forename: E
authors.initials: E
authors.lastname: Taberner
authors.affiliation: Department of Clinical Studies - New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, PA.
authors.forename: R C
authors.initials: RC
authors.lastname: Boston
authors.affiliation: Department of Pathology, Microbiology and Immunology, UC Davis School of Veterinary Medicine, Davis, CA.
authors.forename: S D
authors.initials: SD
authors.lastname: Owens
authors.affiliation: Department of Clinical Studies - New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, PA.
authors.forename: R D
authors.initials: RD
authors.lastname: Nolen-Walston
mesh_terms: D000818:Animals; D001789:Blood Group Antigens / Q000145:classification*; D001787:Blood Group Incompatibility / Q000097:blood / Q000662:veterinary*; D001788:Blood Grouping and Crossmatching / Q000662:veterinary*; D001803:Blood Transfusion / Q000662:veterinary; D004905:Erythrocyte Aging; D004912:Erythrocytes; D006736:Horses / Q000097:blood*
chemical_list: D001789:Blood Group Antigens
keywords: Agglutination; Alloantibodies; Blood type; Hemolysis; Transfusion; Transfusion reaction