Platelet (PLT) transfusions need to take into account the issues that arise due to significant amounts of ABO antigen being present on the platelets surface and anti-ABO alloisogglutinins being present in the donor's plasma. Although relatively rare, acute intravascular haemolytic transfusion reactions (AHTRs) have been caused by passive transfer of anti-A and anti-B antibodies, present in apheresis platelets (APs) of group O donors, across a minor ABO incompatibility (group A, B and AB recipients). To date, improving safety of group O PLT transfusions has focused either on establishing a safe level of alloisogglutinin titer or on reducing the volume of incompatible plasma administered. In this current study we evaluated anti-A and anti-B titers in 70 plasma samples from group O APs donors. Sixty (60) were male donors and ten (10) were female donors. Their age ranged from 20 to 58years old (mean age: 39.8±1.1). The determination of anti-A and anti-B antibodies, was performed using the method of direct agglutination, specifying IgM antibodies (Gel reagent, Ortho BioVue System). Our results showed that, anti-A titers ranged from 2 to 1024 (mean titer: 64), while anti-B titers ranged from 2 to 256 (mean titer: 32). Anti-A titers were significantly higher than anti-B (p<0.01). The critical value of "high-titer" for anti-A and anti-B antibodies, based on our method and internationally accepted criteria, was defined to be at least 64. The frequency of group O APs donors, with "high-titer" anti-A and anti-B was relatively high, 55.8% and 47.2% respectively. There was no statistically significant difference between the donors, when they were divided into two age groups: over/under 40years (p>0.857 and p>0.861). In conclusion, the risk of haemolysis from ABO-incompatible PLT components, due to passive transfused anti-A and/or anti-B alloisogglutinins, is small but present. Transfusion Service Personnel and Clinicians should be aware of the potential risk and they should always be alert and vigilant when it comes to ABO-incompatible platelet transfusions.
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