Practices associated with ABO-incompatible platelet transfusions: a BEST Collaborative international survey
Article first published online: 4 MAY 2010
© 2010 American Association of Blood Banks
Volume 50, Issue 8, pages 1743–1748, August 2010
How to Cite
Lozano, M., Heddle, N., Williamson, L. M., Wang, G., AuBuchon, J. P., Dumont, L. J. and for the Biomedical Excellence for Safer Transfusion (BEST) Collaborative (2010), Practices associated with ABO-incompatible platelet transfusions: a BEST Collaborative international survey. Transfusion, 50: 1743–1748. doi: 10.1111/j.1537-2995.2010.02642.x
- Issue published online: 2 AUG 2010
- Article first published online: 4 MAY 2010
- Received for publication December 15, 2009; revision received January 31, 2010, and accepted February 3, 2010.
BACKGROUND: There is a lack of evidence for guiding the best strategy for ABO selection of platelet (PLT) transfusions. As a baseline for future studies, the BEST Collaborative performed an international survey of current practices in this area.
STUDY DESIGN AND METHODS: An international survey was sent via BEST members to transfusion services and hospitals requesting the demographics of the transfused patient population, ABO matching policies, anti-A and anti-B measurements in PLT concentrates (PCs), and practices regarding ABO-incompatible PC transfusions to adult and pediatric patients.
RESULTS: We received 126 responses from 14 countries, 59% from Europe. Most of them were from local/community (42%) and university hospitals (39%) serving between 500 and 1500 beds; 50.4% transfused fewer than 1000 PCs per year. One-fifth of respondents (19.4%, mainly local/community hospitals) did not have a written policy for selecting ABO-incompatible PCs. Significant practice variation was reported when ABO-mismatched PLTs were given to adults: for PCs suspended in 100% plasma, 29% to 43% of respondents selected any ABO group available; 52% to 61% selected units with compatible supernatant; and, in the case of minor ABO incompatibility, 43% to 54% did not take any specific action. In contrast if ABO-identical PCs were not available for a pediatric recipient, for PCs resuspended in 100% plasma, 71% to 82% selected PCs so the supernatant plasma would be compatible with patient's red blood cells.
CONCLUSION: Considerable practice variation exists when transfusing ABO-incompatible PCs, suggesting an opportunity for research to inform evidence-based practices.