Minimal variation in anti-A and -B titers among healthy volunteers over time

Abstract

Diagnostic study, level V.

Isohemagglutinin titering performed on an automated solid‐phase and hemagglutinin‐based analyzer is comparable to results obtained by manual gel testing

“…Automated titrations were performed on a Galileo NEO instrument (Immucor) as previously described, and utilizing an IUO assay, identical to the now approved assay, at the time of testing . The initial IgG or IgM titer result could be quantified to a dilution as high as 128.…”

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“…However, such significant fluctuations in donor titers over time may be relatively uncommon. In fact, a recent study described stable IgM and IgG anti‐A and anti‐B titers among 56 healthy adult volunteers in southern Denmark who had their antibody titers measured every 3 months over a 1‐year period . These results are interesting because these volunteers were free to go about their daily activities over the course of the year that might have included changing their diets or receiving vaccinations, and yet overall there were only small variations in their antibody titers during the study period.…”

“…Among the 34 centers using group A plasma, there was substantial variation in the amount of group A plasma that could be issued; several hospitals limited the number of units that could be transfused while the majority (21/34, 62%) did not impose a limit on the number of group A plasma units for these patients. The majority (27/34, 79%) of respondents did not determine the anti‐B titer in the group A plasma that was issued to trauma patients, while the others used a maximum anti‐B titer of between less than 25 and less than 100 . The safety of the use of group A plasma in trauma (STAT) study, where 76% of the participants did not determine the titer of anti‐B in the group A plasma issued to trauma patients, found no difference in early mortality, in‐hospital mortality, or hospital length of stay between the group B/AB trauma recipients (n = 354) who received group A plasma during their resuscitation versus the group A trauma patients (n = 809) who also received group A plasma.…”

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“…There exists no standard for answering this question, but there is some experience to guide decision making. In a study of 56 healthy adult volunteers in southern Denmark whose anti‐A and/or ‐B was measured every 3 months for a period of 1 year using an automated solid‐phase instrument, the overall pooled standard deviation (SD) between these serial titer measurements ranged from 0.30 to 0.47 log 2 titer steps . For reference, a titer of 8 would be equivalent to a log 2 titer step of 3 and a titer of 16 would be equivalent to a log 2 titer step of 4, so the pooled SDs of these 56 volunteers reflects a variation of less than half of a titer dilution.…”