In-vitro Dilution of Human Plasma to Reduce ABO Antibody Titer Levels While Preserving Coagulation Factors

The objective of this study was to prepare universal plasma by mixing Group A and Group B plasma with normal saline in varying proportions. This prospective in vitro study involved mixing blood group A and B plasma in ratios of 1:1, 3:1, 1:3, and with normal saline in ratios of 1:1:1, 2:2:1, and 1:1:2. The titration of IgG and IgM levels of anti-A and anti-B antibodies, as well as fibrinogen and factor VIII levels, were performed. The titers of anti-A and anti-B antibodies of both IgG and IgM types were found to have significantly decreased in all ratios compared to the control sample. Coagulation factors were found to be higher than the allowable limit when simple plasma mixing ratios (1:1, 3:1, and 1:3) were used, while they significantly decreased upon dilution with normal saline in 1:1:1 and 1:1:2 ratios. In conclusion, the mixing of A and B blood group plasma at a fixed ratio may be a promising strategy for the preparation of universal plasma with a low titre of haemolytic antibodies, while maintaining an adequate amount of coagulation factors.