Expression of ABO blood group antigen on platelets of blood donors / 中国输血杂志

【Objective】 To study the expression level of ABO blood group antigen on the surface of platelets of blood donors. 【Methods】 A total of 506 donors with normal ABO blood group were selected to analyze the ABO antigen on platelets by flow cytometry. Among them, 30 donors were selected to monitor the changes of ABO antigen on platelets during the storage period, and the remaining 476 to analyze the expression difference of ABO antigen among blood donors. 【Results】 The ABO antigen on platelets of each sample fluctuated slightly but was relatively stable over 1~7 days in vitro. According to MFI values, the donors were divided into low-, moderate- and high- expression groups, with the average frequency of 59.6%, 35.5% and 4.9%, respectively. The A and B antigens of blood group AB platelets exhibited a competitive co-expression pattern. 【Conclusion】 Most individuals have low-expression phenotype of ABO antigen on platelets and can be potential platelet donors for ABO-incompatibility transfusion, which is helpful to improve platelets transfusion strategy.

Acute Hemolytic Transfusion Reaction due to ABO-Incompatible Blood Transfusion: A Fatal Case Report and Review of the Literature / 대한수혈학회지

A 77-year-old female patient who was suspected to have had an acute hemolytic transfusion reaction was admitted to the emergency room. She received one unit of type A red blood cells in a type B patient during a total knee arthroplasty operation at another medical institution. ABO-incompatible transfusion was carried out due to an identification error between the patient and blood product. At the time of admission, acute hemolytic reaction, lactic acidosis, and disseminated intravascular coagulation were observed. She was admitted to the intensive care unit and received continuous renal replacement therapy. She maintained renal function and was moved to the general ward on the 7th day. Complications such as pulmonary edema, gastrointestinal bleeding, and ischemic colitis persisted, and the patient died on the 111th after admission. This case is the first report of death due to an ABO-incompatible transfusion in Korea. Efforts to establish a safe transfusion environment are necessary not only at individual medical institutions but also at the national level.

Elimination of Causative Antibody by Plasma Exchange in a Patient with an Acute Hemolytic Transfusion Reaction / 대한수혈학회지

An ABO-incompatible transfusion is a very rare event but it can cause severe adverse effects, including death. The prognosis is affected by various factors, such as the volume of infusion, underlying diseases, and immunologic state. Until now, however, there has been no consensus regarding the treatment of an ABO-incompatible transfusion except for conservative treatment. A 57 year-old male patient visited the authors' emergency unit with multiple trauma due to a car accident. He had a deep laceration on his left neck accompanied by severe bleeding. Because of his low blood pressure and low hemoglobin level due to bleeding, an emergency transfusion was attempted. Unfortunately, one unit of RBC was transfused incorrectly into the patient due to a clerical error during the identification of the patient. The patient was typed as O, RhD positive; the RBC administered was A, RhD positive. After the transfusion, the patient showed an acute hemolytic transfusion reaction due to gross hematuria. Plasma exchange was attempted and medical treatment with high dose steroid with diuretics was done simultaneously. Two cycles of plasma exchange were done and the patient appeared to recover from the acute adverse effects of the transfusion. The plasma exchange was stopped and medical treatments for the transfusion reactions were maintained for ten days. The patient recovered fully and was discharged after one month. Based on this case, although more studies are necessary for approval as a standard therapy, this case suggests that immediate plasma exchange with medical treatment can be very helpful for eliminating the isoagglutinins in ABO-incompatible transfusions.