EVALUATION OF CHANGES IN HEMOGLOBIN LEVELS ASSOCIATED WITH ABO-INCOMPATIBLE PLASMA IN APHERESIS PLATELETS

BACKGROUND: Hemolytic transfusion reaction is considered a rare compli cation of platelet transfusion. If minor ABO incompatibility exists (d onor antibody directed against recipient's red cells [plasma-incompati ble platelets]), however, the antibodies present in the plasma of plat elets may cause acute hemolysis. A retrospective study was performed t o identify possible hemolysis related to the transfusion of plasma-inc ompatible apheresis platelets. STUDY DESIGN AND METHODS: Acute hemolys is due to low-titer anti-A present in group O apheresis platelets tran sfused to a group A patient is reported. Pretransfusion and posttransf usion hemoglobin levels were evaluated in 16 non-group O autologous bo ne marrow transplant patients receiving apheresis platelets. All patie nts received, within 24 hours, both ABO-identical and plasma-incompati ble platelet transfusions. No red cells were transfused during the tim e between the collection of the pretransfusion and posttransfusion hem oglobin samples. RESULTS: A total of 24 evaluable paired platelet tran sfusions in the 16 patients were compared. The mean change in hemoglob in following transfusion of the ABO-identical and plasma-incompatible platelets was -0.50 g per dL and -0.11 g per dL, respectively (p = 0.1 93). CONCLUSION:There was no significant change in the hemoglobin conc entration associated with the transfusion of plasma-incompatible apher esis platelets (minor ABO incompatibility) in our study group. The cas e reported here represents the only hemolytic transfusion reaction ide ntified among 46,176 platelet transfusions performed at this hospital, despite approximately 21 percent of all platelet transfusions being p lasma incompatible. The risk of such a reaction remains low.