Novel In-line Filter Reduces ABO Circulating Antibodies in Whole Blood

Area of Science:

• Transfusion Medicine
• Hematology
• Immunology

Background:

• Low titer O whole blood (LTOWB) is crucial for trauma resuscitation.
• High antibody titers exclude up to 25% of eligible donors.
• A novel in-line filter aims to remove donor antibodies from whole blood.

Purpose of the Study:

• Evaluate the efficacy of a novel in-line filter in reducing antibody titers in whole blood.
• Assess the filter's impact on whole blood composition and coagulation.
• Determine the filter's performance across different infusion methods.

Main Methods:

• Whole blood units were spiked with anti-A and anti-B antibodies to simulate high titers.
• Simulated infusion was performed using gravity, rapid manual, and automated methods, with and without the filter.
• Blood composition and coagulation potential were analyzed using cell counts, flow cytometry, thromboelastometry, and aggregometry.

Main Results:

• The in-line filter significantly reduced anti-A and anti-B titers across all infusion methods.
• Gravity filtration showed the greatest antibody reduction but also the most significant changes in blood parameters.
• Mild alterations in white blood cell count, platelet count, hematocrit, hemoglobin, and coagulation parameters were observed.

Conclusions:

• The in-line filter effectively reduces antibody titers in whole blood, offering a potential solution to donor pool limitations.
• Filtration induces minor hematologic and coagulation changes, maintaining essential hemostatic properties.
• Further research is needed to optimize filtration and assess clinical impact, potentially enabling the use of high-titer donors.