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. 2011 Jan;51(1):92-6.
doi: 10.1111/j.1537-2995.2010.02759.x.

A practical strategy to reduce the risk of passive hemolysis by screening plateletpheresis donors for high-titer ABO antibodies

Karen Quillen  1 , Sherry L Sheldon, Jennifer A Daniel-Johnson, A Hallie Lee-Stroka, Willy A Flegel
Affiliations

A practical strategy to reduce the risk of passive hemolysis by screening plateletpheresis donors for high-titer ABO antibodies

Karen Quillen et al. Transfusion. 2011 Jan.

Abstract

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.

Study design and 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.

Conclusion: 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.

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Conflict of interest statement

There are no conflicts of interest to disclose. The views expressed in this paper are those of the authors and are not to be construed as the official position of the United States Department of Health and Human Services.

Figures

Figure 1
Figure 1
Donors identified with high-titer ABO antibodies as a function of plasma dilution. Dilutions were evaluated at 1in150 (n = 1,206), 1 in 200 (n = 507) and 1in 250 (n = 923). The percentage of identified donors is shown for blood group O (open bar □), A (hatched bar formula image), and B (closed bar ■).
See this image and copyright information in PMC

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