Risks of hemolysis due to anti-A and anti-B caused by the transfusion of blood or blood components containing ABO-incompatible plasma.

TitleRisks of hemolysis due to anti-A and anti-B caused by the transfusion of blood or blood components containing ABO-incompatible plasma.
Publication TypeJournal Article
Year of Publication2013
AuthorsBerseus O, Boman K, Nessen SC, Westerberg LA
JournalTransfusion
Volume53 Suppl 1
Pagination114S - 123S
Date Published2013
ISBN Number1537-2995
Other Numberswdn, 0417360
Keywords*Blood Component Transfusion/ae [Adverse Effects], *Blood Component Transfusion/mo [Mortality], *Blood Group Incompatibility/mo [Mortality], *Wounds and Injuries/mo [Mortality], ABO Blood-Group System/im [Immunology], Blood Group Incompatibility/im [Immunology], Hemolysis/im [Immunology], Humans, Plasma/im [Immunology], Risk Factors
Abstract

BACKGROUND: The increasing use of fresh blood group O whole blood in acute trauma medicine makes it important to reevaluate the issue of hemolytic reactions related to the transfusion of ABO-incompatible plasma., STUDY DESIGN AND METHODS: This review summarizes and evaluates published articles and case reports concerning hemolytic reactions in connection with the transfusion of group O whole blood or blood products to nongroup O recipients., RESULTS: In 1945-1986, 15 nonmilitary publications reported hemolytic transfusion reactions with group O blood/blood products. All patients recovered except for two fatalities. Late in World War II and during the Korean and Vietnam wars and onward in Iraq and Afghanistan only "low anti-A, anti-B titer" group O whole blood has been used as universal blood. In spite of a large number of units transfused, there are no reports of hemolytic reactions. Twenty-five publications report hemolytic reactions after transfusion of group O platelets to nongroup O recipients. In all patients but one, the titer of the implicated A- or B-antibody was >100 (saline) or >400 (antiglobulin) and all cases with an infused volume of incompatible plasma 1000., CONCLUSION: In emergency lifesaving resuscitation, the risk of hemolytic transfusion reactions from transfusion of group O blood to nongroup O recipients constitutes risk that is outweighed by the benefits. A low titer of anti-A/B will minimize the risk for a hemolytic reaction, particularly if the screening is repeated after an immunization episode, e.g., blood transfusion, vaccination, or pregnancy.Copyright © 2013 American Association of Blood Banks.

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