Significant numbers of apheresis-derived group O platelet units have "high-titer" anti-A/A,B: implications for transfusion policy
Significant numbers of apheresis-derived group O platelet units have "high-titer" anti-A/A,B: implications for transfusion policy
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DOI：
10.1111/j.1537-2995.2004.03290.x
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发表时间：
2004-06-01
期刊：
影响因子：
2.9
通讯作者：
Hillyer, CD
中科院分区：
文献类型：
--
作者：
Josephson, CD;Mullis, NC;Hillyer, CD
将O组单供者单采血小板（SDP）输注给A组受者导致血管内溶血和死亡。由于特定类型的SDP的可用性低，输血服务有时会发布ABO不匹配的PLT。在观察了两例A组患者输注O SDP后发生急性溶血的病例后，其中两种受体洗脱液均显示抗A特异性，开始了一项前瞻性研究，以确定O组SDP中“高滴度”抗A/A，B的流行率。缓冲卡（通常反映IgM抗体）或抗IgG凝胶卡的滴度分别至少为64和/或256，被认为极高。28%和39%的样本分别显示出极高的抗A/ A、B IgM和IgG滴度。IgM滴度分别为1：64（18%）、128（6%）和256（4%），而IgG滴度分别为1：256（28%）、512（7%）、1024（2%）和2048（2%）。因此，在O组SDP输注给A组受者期间，轻微侧ABO错配和潜在血管内溶血的风险可能是显著的。根据这些数据，制定了一项政策，在“组外”输血前检测O SDP中的抗A/AB滴度。
Transfusion of group O single-donor apheresis PLTs (SDP) to group A recipients has resulted in intravascular hemolysis and mortality. Owing to low availability of type-specific SDPs, transfusion services sometimes issue ABO-mismatched PLTs. After observing two cases of acute hemolysis following infusion of O SDPs to group A patients, where both recipient eluates revealed anti-A specificity, a prospective study to determine the prevalence of "high-titer" anti-A/A,B in group O SDPs was commenced.One hundred group O SDP samples were tested. Titers of at least 64 and/or 256 from either buffered (generally reflective of IgM antibodies) or anti-IgG gel cards, respectively, were considered critically high. Twenty-eight and 39 percent of samples revealed critically high anti-A/ A,B IgM and IgG titers, respectively. IgM titers were at 1:64 (18%), 128 (6%), and 256 (4%), whereas IgG titers were at 1:256 (28%) 512 (7%), 1024 (2%), and 2048 (2%).The prevalence of critical anti-A/A,B titers in group O SDPs is relatively high. Thus, the risk of minor side ABO mismatch and potential intravascular hemolysis during group O SDP transfusion to group A recipients may be significant. Based on these data, a policy was instituted to test anti-A/AB titers in O SDPs prior to "out-of-group" transfusion.