Factors that predict outcome after ABO-incompatible RBC transfusions are not well defined. We studied whether the volume of incompatible blood transfused would determine the signs and symptoms and survival outcome for ABO-incompatible RBC transfusions. We reviewed ABO-incompatible RBC transfusions from our institutions and our consultations for 35 years and from a survey of America's Blood Centers' members regarding causes, volume, signs, symptoms, and outcomes of ABO-incompatible RBC transfusions in their service areas from 1995 through 2005. All ABO-incompatible transfusions were due to error; 26 (62%) of 42 occurred at the patient's bedside. Of 36 patients who received more than 50 mL of incompatible blood, 23 (64%) manifested signs or symptoms related to the incompatible transfusion, and 6 (17)% died. Only 3 (25%) of 12 patients who received 50 mL or less of incompatible blood had associated signs or symptoms, and none died. Hypotension, hemoglobinuria, and/or hemoglobinemia were the most frequent findings in survivors and patients who died.ABO-incompatible RBC transfusion does not inevitably mean death or even occurrence of symptoms. Prompt recognition and discontinuation of the transfusion are critical because transfusing less ABO-incompatible blood may minimize signs and symptoms and may prevent death.

Even following the introduction of MP-NAT, a preseroconversion donation with a viral load of

Washing of platelet components for transfusion may be indicated in selected patients. This study was designed to determine a protocol using an automated cell processor to remove plasma proteins from pooled platelet concentrates, stored at 20 to 24 degrees C with constant rotation. A 1500-ml, 0.9% saline-wash procedure is described. Eight percent of the platelets were lost with the procedure (range, 0-19%), while a mean of 99.6 percent of the plasma protein was removed (range, 99.2-99.8%). The clinical effectiveness of maternal platelets washed by this method was demonstrated in a case of alloimmune neonatal thrombocytopenia.

We have used the NCI‐IBM 2997 cell separator in 85 leukapheresis and 34 plateletpheresis procedures. Using hydroxyethyl starch (HES)and steroid pretreatment, our mean granulocyte yield was 19.3 billion cells in a mean product volume of 270.5 ml, containing 10.6 ml of red blood cells. The mean platelet yield during leukapheresis was 18.5 × 1010, as compared with 37.2 × 1010 when plateletpheresis alone was performed. There was a strong correlation between the mean level of granulocytes in the blood before leukapheresis and the granulocyte yield in the product. Other variables well‐correlated with granulocyte yield were the red blood cells in the product, the total blood volume processed, and the product volume. Platelets obtained during plateletpheresis were significantly correlated with the total blood volume processed and with the volume of red blood cells in the product. Donor reactions were no more frequent with the IBM 2997 than with other pheresis systems. This appears to be the system that can provide the best granulocyte yields at the present time.