Comparison of abo antibody levels in apheresis platelets suspended in platelet additive solution and plasma

Kc, Gayathiri; Murugesan, Mohandoss; Nayanar, Sangeetha K; Malodan, Riyas; Padmanaban, Maya

doi:10.1016/j.htct.2020.03.008

Cited by 5 publications

(3 citation statements)

References 8 publications

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“…Our study supports this recommendation as we have observed a significant reduction in ABO antibodies, specifically for both anti-A and anti-B antibodies in the PAS group. This is due to the 65% plasma replacement with PAS causing a dilution effect [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Platelet Additive Solutions as an Alternative Storage Medium of Apheresis Platelets to Reduce ABO Antibody Titer for ABO-Incompatibility Platelet Transfusion

Adzahar,

Hassan,

Zulkafli

et al. 2023

Cureus

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IntroductionPlatelet additive solutions (PASs) are nutrient media commonly used to replace and reduce the need for storage plasma. They are an alternative medium to maintain high-quality platelets lasting longer on the shelf for about seven days. Platelets with high titer of ABO antibody can pose a hemolytic transfusion reaction (HTR) risk if units are given across the ABO barrier. The risk of complication is greater when group O platelet is released to non-group O patients. The PAS has been known as a safe medium, where the titer of ABO antibodies is expected to be diluted. In this study, we compared the anti-A and anti-B antibody titers of apheresis platelets in PAS and non-PAS (plasma) as the suspending media. MethodsA total of 20 apheresis platelet donors were selected, with seven from blood group A, eight from blood group B, and five from blood group O. The platelets were collected using an Amicus cell separator. They were suspended in PAS and plasma before being stored at a temperature range of 22-24 º C. Anti-A (blood group B and O) and Anti-B (blood group A and O) antibody titers were measured and compared between the two suspending media. Wilcoxon signed-rank test is used for statistical analysis, and a p-value <0.05 is considered significant. ResultsThe median titer of the anti-A antibody of apheresis platelets showed a significant difference between suspended in PAS (2.50) and plasma (4.00), p=0.002. Similar findings were also seen with the median titer of the anti-B antibody of apheresis platelet, in which it showed a significant difference between suspended in PAS (2.00) and plasma (4.00), p=0.004. It was observed that there was a significant reduction in both anti-A and anti-B antibody titers in the PAS as compared to the plasma group. ConclusionThe decrease in ABO antibody titer in apheresis platelets stored with PAS can be beneficial for patients. This reduces the risk of HTRs if ABO-incompatible platelet units need to be issued. Thus, using PAS as a storage medium significantly improves platelet inventory management without compromising patient safety.

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Section: Discussionmentioning

confidence: 99%

Platelet Additive Solutions as an Alternative Storage Medium of Apheresis Platelets to Reduce ABO Antibody Titer for ABO-Incompatibility Platelet Transfusion

Adzahar,

Hassan,

Zulkafli

et al. 2023

Cureus

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“…Use of PAS‐E instead of donor plasma to suspend the platelets is expected to further dilute and reduce the amount of isohemagglutinins in the supernatant of platelet components. Studies comparing ABO antibody levels in apheresis platelets suspended in PAS vs plasma showed a two‐fold reduction in antibody titers in the former, albeit the degree of dilution may vary slightly depending on the PAS formulation used and the production process 22–25 . However, using the current process of requiring all donations included in the pooled platelets to be “low titre” in order to label the component, the number of platelets labeled will decrease substantially due to the increase in donor contributions from four to seven donors per pool.…”

Section: Introductionmentioning

confidence: 99%

“…Studies comparing ABO antibody levels in apheresis platelets suspended in PAS vs plasma showed a two-fold reduction in antibody titers in the former, albeit the degree of dilution may vary slightly depending on the PAS formulation used and the production process. [22][23][24][25] However, using the current process of requiring all donations included in the pooled platelets to be "low titre" in order to label the component, the number of platelets labeled will decrease substantially due to the increase in donor contributions from four to seven donors per pool. This could impose significant limitations on national inventory of labeled low titre platelets.…”

Section: Introductionmentioning

confidence: 99%

Isohemagglutinin titration in pooled and apheresis platelets

Hua,

Lyon,

Duke

et al. 2024

Transfusion

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BackgroundPlatelet inventory constraints necessitate ABO‐incompatible platelet transfusion. Many minimize the hemolytic impact by confirming low titre (LT) donor isohemagglutinins. This process is costly. Pathogen‐reduced platelets (PRP) in platelet additive solutions (PAS) will dilute plasma and decrease high‐titre isohemagglutinins (HT). We determined the proportion of HT platelets and incompatible transfusions for units suspended in plasma to reassess the need for titres following introduction of PRP/PAS.Study Design and MethodsOur titre method is manual tube (1:50) dilution of platelet supernatant from apheresis or whole blood derived buffy coat pools suspended in plasma, tested with A1/B red cells. Testing included 49,058 pooled and 11,738 apheresis platelets over 4 years. The HT proportion, rate of out‐of‐group transfusions, and hemolytic reactions were determined. The impact of PAS dilution was estimated.ResultsTotally 60,796 platelet units were tested. Group O pooled and group B apheresis platelets had HT in 6.6% and 5.7%, respectively. Group A pooled and apheresis platelets included 2% with HT. Approximately 25% of platelets transfused were ABO‐incompatible and no hemolytic reactions were reported. Based on the proportions of PAS‐E and plasma for PRP platelets, plasma from each donor comprises 11 mL (6% of total volume) vs 20‐257 mL in untreated pools. PAS‐E will replace and dilute residual plasma by at least 50%.DiscussionRare platelet pools may demonstrate HT. PRP platelets with PAS will reduce titres and may abrogate the need for titration. A strategy of group specific transfusion or transfusion of group A PRP platelet transfusions may be a safe alternative.

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