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Hemolysis following platelet transfusions from ABO-incompatible donors
Transfusion
|January 1, 1985
Summary
Group O platelet transfusions can cause severe hemolytic transfusion reactions due to high-titer isoagglutinins. Careful patient and product matching is crucial to prevent red blood cell hemolysis.
Area of Science:
- Transfusion Medicine
- Immunology
- Hematology
Background:
- Group O platelet concentrates contain potent isoagglutinins (anti-A and anti-B).
- These isoagglutinins can pose a risk for hemolytic transfusion reactions (HTRs) in non-group O recipients.
Observation:
- Two cases of HTRs associated with group O platelet transfusions are presented.
- Case 1: A group A child experienced a severe reaction from group O plasma with high-titer IgG anti-A.
- Case 2: A group B adult developed significant red blood cell hemolysis after receiving a small volume of group O plasma containing anti-B.
Findings:
- High-titer IgG anti-A (titer 32,000) in 200 ml of plasma caused a severe HTR in a group A patient.
- Anti-B (titer 16,000) in 50-70 ml of plasma led to approximately 40% red cell hemolysis in a group B patient.
Implications:
- The presence of clinically significant isoagglutinins in group O platelet products necessitates careful consideration.
- Strategies to mitigate HTR risk, such as pre-transfusion testing or component modification, may be warranted.
- These findings highlight the importance of understanding antibody titers in transfusion safety for platelet products.