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Risks of hemolysis due to anti-A and anti-B caused by the transfusion of blood or blood components containing ABO-incompatible plasma.
MedLine Citation:
PMID:  23301963     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: The increasing use of fresh blood group O whole blood in acute trauma medicine makes it important to reevaluate the issue of hemolytic reactions related to the transfusion of ABO-incompatible plasma.
STUDY DESIGN AND METHODS: This review summarizes and evaluates published articles and case reports concerning hemolytic reactions in connection with the transfusion of group O whole blood or blood products to nongroup O recipients.
RESULTS: In 1945-1986, 15 nonmilitary publications reported hemolytic transfusion reactions with group O blood/blood products. All patients recovered except for two fatalities. Late in World War II and during the Korean and Vietnam wars and onward in Iraq and Afghanistan only "low anti-A, anti-B titer" group O whole blood has been used as universal blood. In spite of a large number of units transfused, there are no reports of hemolytic reactions. Twenty-five publications report hemolytic reactions after transfusion of group O platelets to nongroup O recipients. In all patients but one, the titer of the implicated A- or B-antibody was >100 (saline) or >400 (antiglobulin) and all cases with an infused volume of incompatible plasma <200 mL were related to anti-A or anti-B antiglobulin titers >1000.
CONCLUSION: In emergency lifesaving resuscitation, the risk of hemolytic transfusion reactions from transfusion of group O blood to nongroup O recipients constitutes risk that is outweighed by the benefits. A low titer of anti-A/B will minimize the risk for a hemolytic reaction, particularly if the screening is repeated after an immunization episode, e.g., blood transfusion, vaccination, or pregnancy.
Authors:
Olle Berséus; Kjell Boman; Shawn C Nessen; Lars A Westerberg
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Transfusion     Volume:  53 Suppl 1     ISSN:  1537-2995     ISO Abbreviation:  Transfusion     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  United States    
Other Details:
Languages:  eng     Pagination:  114S-23S     Citation Subset:  IM    
Copyright Information:
© 2013 American Association of Blood Banks.
Affiliation:
Department of Transfusion Medicine, Örebro University Hospital, Örebro, Sweden; Swedish Army Special Forces, Sweden; US Army Medical Corps, 212th Combat Support Hospital, Miseau, Germany.
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