Risk analysis of transfusion of cryoprecipitate without consideration of ABO group. Issue 1 (10th October 2020)

• Record Type: Journal Article
• Authors: Hadjesfandiari, Narges; Levin, Elena; Serrano, Katherine; Yi, Qi‐Long; Devine, Dana V.
• Is Part Of: Transfusion. Volume 61:Issue 1(2021)
• Page Start: 29
• Page End: 34
• Publication Date: 2020-10-10
• Subjects: Hematology -- Periodicals; Blood -- Transfusion -- Periodicals; Blood Group Antigens -- Periodicals; Blood Preservation -- Periodicals; Blood Transfusion -- Periodicals; 615
• DOI: 10.1111/trf.16125
• Languages: English
• ISSNs: 0041-1132

Abstract

Abstract: 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. Abstract : See editorial on page 1–4, in this issue