How do I implement an automated screen for high-titer ABO antibody as an inventory management tool for ABO plasma-incompatible platelets?

Transfusion. 2015 Dec;55(12):2783-9. doi: 10.1111/trf.13374. Epub 2015 Oct 7.

Abstract

Background: Plasma volume reduction (PVR) may reduce the risk of hemolysis associated with transfusion of plateletpheresis blood products (PLTs) containing ABO-incompatible plasma. But PVR may delay PLT issue. In collaboration with our blood donor center we evaluated an automated screen of PLT for high-titer ABO antibody and to apply PVR to high-titer PLTs.

Study design and methods: At the donor center, plasma from PLT donors was tested using an automated microplate system (PK7300, Beckman). PK settings were set for a detection cutoff equivalent to 1 in 256 using a manual tube method. The donors associated with high-titer PLTs were characterized by sex and age. In the transfusion service, the number of PVR procedures was evaluated before and after implementation of the high-titer screen.

Results: During validation, 157 of 1008 PLT units (15%) were positive by the automated method versus 121 (12%) by manual method. After implementation, 2112 of 15,240 PLT units were high-titer, with higher frequency in donations from females versus males (18% vs. 12%, p < 0.0001). The PLT PVR rate was reduced by 50%.

Conclusion: Implementation of an automated method to screen PLTs for high-titer ABO antibody at the donor center improves the inventory management of PLTs containing ABO-incompatible plasma at the hospital transfusion service.

MeSH terms

  • ABO Blood-Group System / immunology*
  • Adult
  • Aged
  • Blood Group Incompatibility / diagnosis*
  • Blood Platelets / immunology*
  • Female
  • Humans
  • Isoantibodies / blood*
  • Male
  • Middle Aged
  • Plasma Volume

Substances

  • ABO Blood-Group System
  • Isoantibodies