Survey of quality control testing practices on low titer group O whole blood in the United States

Use of low titer group O whole blood (LTOWB) continues to increase in the United States (US). This survey sampled the quality control (QC) practices among the largest blood collectors in the US.

A survey on LTOWB collection, QC testing, and distribution was developed and electronically distributed to the chief medical officers of 16 large blood collectors in the US. Only complete survey responses were included.

The response rate was 10/16 (63%) representing approximately 80% of the US blood supply as estimated by the respondents. All of the respondents collected LTOWB from males and 7/10 (70%) also collected from never pregnant females. Eight out of nine (89%) centers that repeat donor anti-A and -B titer testing do so on every donation, with 1/9 (11%) respondent testing previously low titer donors annually. The most common antibody titer threshold that defined low titer was <200 (6/10, 60%). The most common LTOWB collection method was with a platelet-sparing filter in CPD 5/10 (50%). 7/10 (70%) respondents performed QC testing on LTOWB units; all of these respondents collected leukoreduced LTOWB and performed residual leukocyte count testing following leukoreduction. 6/7 (86%) performed residual red blood cell (RBC) recovery counts in the laboratory, 4/7 (57%) measured the unit's weight/volume, while 1/7 (14%) center measured the time taken for leukoreduction. The most often frequency of QC testing was monthly.

Current practice at US blood suppliers for QC testing on LTOWB units was limited primarily to testing associated with leukoreduction and RBC counting.