Sarah K Harm1, Mark H Yazer2, Carolina B Bub3, Claudia S Cohn4, Eapen K Jacob5, Jose M Kutner3, David C Mair6, Jay S Raval7, Beth H Shaz8, Alyssa Ziman9, Nancy M Dunbar10. 1. Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, Burlington, Vermont. 2. Department of Pathology and Laboratory Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania. 3. Hemotherapy and Cell Therapy Department, Hospital Israelita Albert Einstein, Sao Paulo, Brazil. 4. Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota. 5. Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota. 6. Blood Services - West Division, American Red Cross, Minnesota. 7. Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, North Carolina. 8. New York Blood Center, New York, New York. 9. Wing-Kwai and Alice Lee-Tsing Chung Transfusion Service, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California. 10. Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
Abstract
BACKGROUND: ABO-incompatible platelet transfusions are common, and transfusions with ABO-incompatible plasma are increasing with the use of group A plasma and group O whole blood (WB) in emergencies. Many centers screen blood products for anti-A and/or anti-B titers to help prevent hemolysis from ABO-incompatible transfusions, yet titer methods and definition of high titers are not standardized. STUDY DESIGN AND METHODS: This international multicenter study collected data on anti-A and anti-B titer practices for plasma, apheresis platelet (AP), and WB units from January 2015 through December 2017 to determine the prevalence of high-titer units using local definitions. RESULTS: A total of 87,701 plasma, AP and WB units were screened for high-titer anti-A and/or anti-B. High-titer detection rates for group A plasma ranged 0%-13.6%; group A AP 2.7%-9.3%; group O AP 2.3%-65.7%; and group O WB 6.4%-20.7%. At the one center that collected group B AP, the high-titer rate was 10.9%. High-titer rates varied from month to month, as well as between years for a given month. There was no clear pattern of when high-titer units were donated. CONCLUSION: The prevalence of high-titer plasma, AP, and WB units varies by titer method and local definition of high titer. Even at the lowest titer threshold of 50, a significant proportion of units had a high-titer antibody, although the clinical relevance of this finding needs further investigation.
BACKGROUND: ABO-incompatible platelet transfusions are common, and transfusions with ABO-incompatible plasma are increasing with the use of group A plasma and group O whole blood (WB) in emergencies. Many centers screen blood products for anti-A and/or anti-B titers to help prevent hemolysis from ABO-incompatible transfusions, yet titer methods and definition of high titers are not standardized. STUDY DESIGN AND METHODS: This international multicenter study collected data on anti-A and anti-B titer practices for plasma, apheresis platelet (AP), and WB units from January 2015 through December 2017 to determine the prevalence of high-titer units using local definitions. RESULTS: A total of 87,701 plasma, AP and WB units were screened for high-titer anti-A and/or anti-B. High-titer detection rates for group A plasma ranged 0%-13.6%; group A AP 2.7%-9.3%; group O AP 2.3%-65.7%; and group O WB 6.4%-20.7%. At the one center that collected group B AP, the high-titer rate was 10.9%. High-titer rates varied from month to month, as well as between years for a given month. There was no clear pattern of when high-titer units were donated. CONCLUSION: The prevalence of high-titer plasma, AP, and WB units varies by titer method and local definition of high titer. Even at the lowest titer threshold of 50, a significant proportion of units had a high-titer antibody, although the clinical relevance of this finding needs further investigation.
Authors: Randin C Nelson; Vicki Fellowes; Ping Jin; Hui Liu; Steven L Highfill; Jiaqiang Ren; James Szymanski; Willy A Flegel; David F Stroncek Journal: Transfusion Date: 2020-03-13 Impact factor: 3.337