Summary of platelet minor ABO incompatibility risk-mitigation strategies
| Mitigation strategy . | Drawbacks . |
|---|---|
| Issue only ABO identical or compatible units | Identical or compatible units may not always be available in inventoryPotential for increased outdate rates |
| Limit volume of incompatible plasma | Compatible units may not always be available in inventoryPotential for increased outdate rates |
| Provide pooled whole blood–derived platelets | Pooled platelets are not widely available in the United StatesHemolytic transfusion reactions have been reported in pooled platelet units |
| Provide units suspended in PAS | PAS platelets are not widely available in the United StatesHemolytic transfusion reactions have been reported in PAS units |
| Provide low-titer units | Titer method is not standardizedNo agreed upon high-titer cutoffSubstantial percentage of group O units may be high titer, depending on cutoffSaline titer methods may miss units with high-titer IgG antibodiesHemolytic transfusion reactions have been reported in low-titer units |
| Volume reduction | Shortens shelf lifeDecreases platelet contentIncreases the time required for unit preparation and blood bank workloadNot feasible for emergency transfusions |
| Washing | Shortens shelf lifeDecreases platelet contentIncreases the time required for unit preparation and blood bank workloadNot feasible for emergency transfusions |
| Mitigation strategy . | Drawbacks . |
|---|---|
| Issue only ABO identical or compatible units | Identical or compatible units may not always be available in inventoryPotential for increased outdate rates |
| Limit volume of incompatible plasma | Compatible units may not always be available in inventoryPotential for increased outdate rates |
| Provide pooled whole blood–derived platelets | Pooled platelets are not widely available in the United StatesHemolytic transfusion reactions have been reported in pooled platelet units |
| Provide units suspended in PAS | PAS platelets are not widely available in the United StatesHemolytic transfusion reactions have been reported in PAS units |
| Provide low-titer units | Titer method is not standardizedNo agreed upon high-titer cutoffSubstantial percentage of group O units may be high titer, depending on cutoffSaline titer methods may miss units with high-titer IgG antibodiesHemolytic transfusion reactions have been reported in low-titer units |
| Volume reduction | Shortens shelf lifeDecreases platelet contentIncreases the time required for unit preparation and blood bank workloadNot feasible for emergency transfusions |
| Washing | Shortens shelf lifeDecreases platelet contentIncreases the time required for unit preparation and blood bank workloadNot feasible for emergency transfusions |
IgG, immunoglobulin G; PAS, platelet additive solution.