Correlation Between Hemolysin Testing and ABO Antibody Titers: Establishing Critical Threshold Titer Levels

Area of Science:

• Transfusion Medicine
• Immunology
• Hematology

Background:

• Hemolysis following ABO incompatible (ABOi) plasma transfusion occurs with significant incidence.
• Existing critical titer assessments often rely on post-hemolysis data.
• There is a need for Indian data to establish reliable ABO titer thresholds.

Purpose of the Study:

• To establish a critical threshold for ABO antibody titers in blood donors.
• To correlate hemolysin test results with antibody titers.
• To determine a safe threshold for ABO incompatible plasma transfusion.

Main Methods:

• Prospective observational study involving 'O' blood group voluntary donors.
• Hemolysin testing and antibody titration using the conventional tube technique.
• Receiver Operating Characteristic (ROC) curve analysis to determine critical titer thresholds.

Main Results:

• A total of 350 donors were recruited.
• A critical titer threshold of ≥ 128 for both IgG anti-A and anti-B was identified.
• Titers below 128 were associated with negative hemolysin tests.

Conclusions:

• A threshold of ≥ 128 for IgG anti-A and anti-B is proposed as a critical titer.
• This threshold indicates safety for ABO incompatible plasma transfusion.
• Implementing this threshold may reduce transfusion-related hemolysis.