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.
Bibliographical noteFunding Information:
The study investigators thank Sarai Paradiso and Shiraz Rehmani for their assistance with data abstraction and reporting. Some of the group O WB titer data has been previously published in Yazer MH, Seheult J, Kleinman S, Sloan S, Spinella PC on behalf of the AABB (formerly known as the American Association of Blood Banks)/THOR (Trauma, Hemostasis, Oxygenation Resuscitation Network) working party (Who's afraid of incompatible plasma? A balanced approach to the safe transfusion of blood products containing ABO-incompatible plasma. Transfusion 2018;58:532?8). SKH and MHY are co?first authors.
© 2018 AABB