Transfusion of Uncrossmatched Group O Erythrocyte-containing Products Does Not Interfere with Most ABO Typings.
Journal
Anesthesiology
ISSN: 1528-1175
Titre abrégé: Anesthesiology
Pays: United States
ID NLM: 1300217
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
pubmed:
4
12
2019
medline:
23
6
2020
entrez:
3
12
2019
Statut:
ppublish
Résumé
Group O erythrocytes and/or whole blood are used for urgent transfusions in patients of unknown blood type. This study investigated the impact of transfusing increasing numbers of uncrossmatched type O products on the recipient's first in-hospital ABO type. This was a retrospective cohort study. Results of the first ABO type obtained in adult, non-type O recipients (i.e., types A, B, AB) after receiving at least one unit of uncrossmatched type O erythrocyte-containing product(s) for any bleeding etiology were analyzed along with the number of uncrossmatched type O erythrocyte-containing products administered in the prehospital and/or in hospital setting before the first type and screen sample was drawn. There were 10 institutions that contributed a total of 695 patient records. Among patients who received up to 10 uncrossmatched type O erythrocyte-containing products, the median A antigen agglutination strength in A and AB individuals on forward typing (i.e., testing the recipient's erythrocytes for A and/or B antigens) was the maximum (4+), whereas the median B antigen agglutination strength among B and AB recipients of up to 10 units was 3 to 4+. The median agglutination strength on the reverse type (i.e., testing the recipient's plasma for corresponding anti-A and -B antibodies) was very strong, between 3 and 4+, for recipients of up to 10 units of uncrossmatched erythrocyte-containing products. Overall, the ABO type of 665 of 695 (95.7%; 95% CI, 93.9 to 97.0%) of these patients could be accurately determined on the first type and screen sample obtained after transfusion of uncrossmatched type O erythrocyte-containing products. The transfusion of smaller quantities of uncrossmatched type O erythrocyte-containing products, in particular up to 10 units, does not usually interfere with determining the recipient's ABO type. The early collection of a type and screen sample is important.
Sections du résumé
BACKGROUND
Group O erythrocytes and/or whole blood are used for urgent transfusions in patients of unknown blood type. This study investigated the impact of transfusing increasing numbers of uncrossmatched type O products on the recipient's first in-hospital ABO type.
METHODS
This was a retrospective cohort study. Results of the first ABO type obtained in adult, non-type O recipients (i.e., types A, B, AB) after receiving at least one unit of uncrossmatched type O erythrocyte-containing product(s) for any bleeding etiology were analyzed along with the number of uncrossmatched type O erythrocyte-containing products administered in the prehospital and/or in hospital setting before the first type and screen sample was drawn.
RESULTS
There were 10 institutions that contributed a total of 695 patient records. Among patients who received up to 10 uncrossmatched type O erythrocyte-containing products, the median A antigen agglutination strength in A and AB individuals on forward typing (i.e., testing the recipient's erythrocytes for A and/or B antigens) was the maximum (4+), whereas the median B antigen agglutination strength among B and AB recipients of up to 10 units was 3 to 4+. The median agglutination strength on the reverse type (i.e., testing the recipient's plasma for corresponding anti-A and -B antibodies) was very strong, between 3 and 4+, for recipients of up to 10 units of uncrossmatched erythrocyte-containing products. Overall, the ABO type of 665 of 695 (95.7%; 95% CI, 93.9 to 97.0%) of these patients could be accurately determined on the first type and screen sample obtained after transfusion of uncrossmatched type O erythrocyte-containing products.
CONCLUSIONS
The transfusion of smaller quantities of uncrossmatched type O erythrocyte-containing products, in particular up to 10 units, does not usually interfere with determining the recipient's ABO type. The early collection of a type and screen sample is important.
Identifiants
pubmed: 31789634
doi: 10.1097/ALN.0000000000003069
doi:
Substances chimiques
ABO Blood-Group System
0
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
525-534Investigateurs
David McKenna
(D)
David Stroncek
(D)
Mark Fung
(M)
Alan Tinmouth
(A)
Dana Devine
(D)
Rebecca Cardigan
(R)
Ralph Vassallo
(R)
Marc Germain
(M)
JoAnna Reems
(J)
Henk Garritsen
(H)
Minoko Takanashi
(M)
Simon Stanworth
(S)
Meghan Delaney
(M)
José Cancelas
(J)
Pieter van der Meer
(PV)
Denese Marks
(D)
Claudia Cohn
(C)
Beth Shaz
(B)
Pierre Tiberghien
(P)
Mindy Goldman
(M)
John Girdlestone
(J)
Shibani Pati
(S)
Richard Schäfer
(R)
Joseph Yossi Schwartz
(JY)
Nancy Dunbar
(N)
Monica Pagano
(M)
Cynthia So-Osman
(C)
Femke Noorman
(F)
Torunn Oveland Apelseth
(TO)
Tamir Kanias
(T)
Moritz Stolla
(M)
Emanuele di Angelantonio
(ED)
Katja van den Hurk
(KVD)
Whitney R Steele
(WR)
Christian Erikstrup
(C)
Eva-Maria Merz
(EM)