Seasonal variability is not observed in the rates of high anti-A and anti-B titers in plasma, apheresis platelet, and whole blood units tested by different methods
Seasonal variability is not observed in the rates of high anti-A and anti-B titers in plasma, apheresis platelet, and whole blood units tested by different methods
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DOI：
10.1111/trf.15083
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发表时间：
2019-02-01
期刊：
影响因子：
2.9
通讯作者：
Dunbar, Nancy M.
中科院分区：
文献类型：
--
作者：
Harm, Sarah K.;Yazer, Mark H.;Dunbar, Nancy M.
背景：ABO血型不合的血小板输注很常见，随着A型血浆和O型全血(WB)在急诊中的使用，使用ABO血型不合血浆的输血也在增加。许多中心对血液产品进行抗-A和/或抗-B滴度筛查，以帮助预防ABO血型不合输血引起的溶血，但滴度方法和高滴度的定义没有标准化。研究设计和方法：这项国际多中心研究收集了2015年1月至2017年12月血浆、分离血小板(AP)和WB单位抗-A和抗-B滴度的数据，以确定使用本地定义的高滴度单位的流行率。结果：总共对87,701个血浆、AP和WB单位进行了高滴度抗-A和/或抗-B筛查。A组血浆高滴度检出率为0%~13.6%，A组AP为2.7%~9.3%，O组AP为2.3%~65.7%，O组WB为6.4%~20.7%。在收集B群AP的一个中心，高滴度为10.9%。每个月的高滴度不同，给定月份的不同年份也不同。高滴度单位的捐献时间没有明确的模式。结论：高滴度血浆、AP和WB单位的患病率因滴度方法和局部高滴度单位的定义而异。即使在最低滴度阈值50，有相当大比例的单位具有高滴度抗体，尽管这一发现的临床相关性需要进一步调查。
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.