Premium
Risk analysis of transfusion of cryoprecipitate without consideration of ABO group
Author(s) -
Hadjesfandiari Narges,
Levin Elena,
Serrano Katherine,
Yi QiLong,
Devine Dana V.
Publication year - 2021
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.16125
Subject(s) - cryoprecipitate , titer , medicine , abo blood group system , transfusion medicine , blood transfusion , antibody , immunology , fibrinogen
Background Transfusion medicine standards in Canada state that adult recipients can be transfused with cryoprecipitate of any ABO group, however, not all hospitals follow this guideline. There is a paucity of data on cryoprecipitate anti‐A/B levels to reinforce standards. Study Design and Methods Manual tube antibody titration was performed on 7 units of group O plasma and the corresponding cryosupernatant plasma and cryoprecipitate. IgG/IgM levels were determined by nephelometry. Additionally, 10 cryoprecipitate each from groups A, B, and O were similarly assessed. From the antibody titer distribution among these samples, the probability of making a pool of cryoprecipitate with a titer ≥1:100 was calculated using bootstrap analysis. Results Anti‐A/B titers in cryoprecipitate were equivalent to those in corresponding plasma; partitioning of anti‐A/B activity into cryoprecipitate was not observed. Average IgM concentration was higher in cryoprecipitate than in plasma ( P < .01). However, no correlation between IgM levels and anti‐A/B titers was established. Among 30 cryoprecipitates from routine blood bank inventory, the median antibody titer and mode were 1:32 and 1:16, respectively. Of the samples tested, 4 of 30 and 9 of 30 had titers above 1:100 and 1:50, respectively. The probability of transfusing an adult dose of cryoprecipitate (pool of 10 cryoprecipitate) with a titer higher than 1:100 was calculated to be less than 1 in 3 million. Conclusions This study provides strong evidence to support current Canadian transfusion medicine standards on the safety of transfusion of cryoprecipitate without the need for blood group matching in adult recipients.