ABO-incompatible platelets are associated with increased transfusion reaction rates

Natalie Malvik; Judith Leon; Annette J Schlueter; Chaorong Wu; C Michael Knudson

doi:10.1111/trf.15655

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ABO-incompatible platelets are associated with increased transfusion reaction rates

Journal article

Open access

Peer reviewed

ABO-incompatible platelets are associated with increased transfusion reaction rates

Natalie Malvik, Judith Leon, Annette J Schlueter, Chaorong Wu and C Michael Knudson

Transfusion (Philadelphia, Pa.), Vol.60(2), pp.285-293

02/2020

DOI: 10.1111/trf.15655

PMCID: PMC7769037

PMID: 31912889

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Abstract

ABO compatibility can affect platelet transfusion safety and efficacy, and ABO-incompatible (ABOi) platelets likely increases the risks of transfusion reactions though the magnitude of this risk is unclear. Data collected on all platelet transfusions administered over 36+ months were classified based on patient and product ABO blood group type and merged with a data set that included all transfusion reactions reported during that period. The transfusion reaction rates among various subsets was calculated. In patients greater than 1 year of age, the transfusion reaction rate in the ABO-compatible (ABO-identical) platelet group was 1.0%, while the ABOi platelet group had an elevated reaction rate of 1.7%. The increased reaction rate for ABOi platelets held true even if the analysis were limited to Centers for Disease Control and Prevention/National Healthcare Safety Network qualifying reactions or just allergic or febrile nonhemolytic reactions. The increased reaction rate with ABOi platelets was independent of unit age. Surprisingly, major-incompatible transfusions (A/B antigen incompatible) had the highest rate of reactions, at 2.0%. During the study period, three acute hemolytic reactions were reported out of 2522 plasma-incompatible platelet transfusions (0.12%). Our results find that compatible platelet transfusions have the lowest rate of transfusion reactions. While hemolytic reactions were observed with plasma-incompatible transfusions, the rate was low. Transfusion of ABO antigen-incompatible platelets had the highest rate of transfusion reactions and resulted in a transfusion reaction rate 1.5 to 2 times that of ABO compatible transfusions.

ABO Blood-Group System - metabolism

Blood Group Incompatibility - metabolism

Blood Platelets - physiology

Blood Transfusion - methods

Female

Hemolysis - physiology

Humans

Male

Platelet Transfusion - adverse effects

Transfusion Reaction - metabolism

Details

Title: Subtitle: ABO-incompatible platelets are associated with increased transfusion reaction rates
Creators: Natalie Malvik - University of Iowa Hospitals and Clinics
Judith Leon - University of Iowa Hospitals and Clinics
Annette J Schlueter - University of Iowa Hospitals and Clinics
Chaorong Wu - University of Iowa
C Michael Knudson - University of Iowa Hospitals and Clinics
Resource Type: Journal article
Publication Details: Transfusion (Philadelphia, Pa.), Vol.60(2), pp.285-293
DOI: 10.1111/trf.15655
PMID: 31912889
PMCID: PMC7769037
NLM abbreviation: Transfusion
ISSN: 0041-1132
eISSN: 1537-2995
Grant note: UL1TR002537 / University of Iowa UL1 TR002537 / NCATS NIH HHS
Language: English
Date published: 02/2020
Academic Unit: Pathology; Radiation Oncology
Record Identifier: 9984186536702771

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