Search

Background: Patients receiving hematopoietic stem‑cell transplantation (HSCT) require extensive transfusion support until red blood cell (RBC) and platelet engraftment occurs. The present study was planned to assess the trend of blood component transfusion in the first 100 days of ABO‑compatible (ABOc) and ABO‑incompatible (ABOi) allogeneic matched, related HSCT. Materials and Methods: This was a prospective study conducted in the department of transfusion medicine at a large tertiary health‑care center between 2016 and 2019. Data of component‑wise transfusion from the day of transplant to 100 days posttransplant were collected in all allogeneic matched, related peripheral blood HSCT recipients. Results: During the study duration, there were 62 matched, related HSCT. Of these, 38 were ABOc HSCT, and 24 were ABOi HSCT. The mean CD34+ cell dose harvested by apheresis was 7.7 and 6.2 million/kg for ABOc and ABOi categories, respectively. The most common component transfused was platelets (9.15 mean random donor platelet concentrates [RDPCs] units, 4.45 mean single donor platelet concentrates [SDPCs] units issued), followed by red cells (6.9 mean RBC units issued), with fresh frozen plasma (FFP) (3.2 mean FFP units issued) being the least frequently requested component. The mean number of red cells, RDPC, SDPC, and FFP issued for transfusion in the ABOc category were 7.1, 8.7, 5.5, and 2.3, respectively, while it was 6.7, 9.6, 3.4, and 4.1 in ABOi category, respectively. The component‑wise difference in the number of units transfused in the first 100 days was not found to be statistically significant (P < 0.05) between the two categories. Conclusions: Contrary to the usual belief that ABOi transplants require more transfusions, the transfusion practices at the present center did not show a significant difference in component‑wise transfusions between the two categories. A restrictive transfusion strategy was an important measure in reducing the number of transfusions. [ABSTRACT FROM AUTHOR]

BACKGROUND AND AIMS: When determining ABO antibody titers, immunoglobulin G (IgG) antibodies can be masked by immunoglobulin M (IgM) antibodies. Hence, the measurement of actual concentration of IgG requires methods like heat inactivation (HI) of plasma. This study was aimed at determining the effects of HI on IgM and IgG titers performed by conventional tube technique (CTT) and column agglutination technique (CAT). MATERIALS AND METHODS: This was a prospective, observational study conducted from October 2019 to March 2020. All consecutive A, B, and O group donors who gave consent for participation were included. All samples were consecutively tested by CTT and CAT, before and after HI (pCTT, pCAT). RESULTS: A total of 300 donors were included. IgG titers were found to be more than IgM titers. For group O, IgG titer results were higher for both anti-A and anti-B compared to group A and B. For group A, B, and O, pretreatment results were higher than posttreatment IgG titer results. Median anti-A titers were similar to median anti-B titers across all categories. Median IgM and IgG titers were higher for group O individuals than nongroup O individuals. There was reduction in IgG and IgM titers after HI of plasma. One log reduction in median titers was observed when ABO titers were performed by CAT and CTT. CONCLUSION: There is one log difference between median antibody titers estimated using heat inactivated and nonheat inactivated plasma. The use of HI for ABO isoagglutinin titer estimation can be considered in low resource settings. [ABSTRACT FROM AUTHOR]

Background and Aims: Titration is a time-consuming procedure even when automated. The aim of the present study was to identify the variation in ABO titers with donor characteristics in Group O individuals. Materials and Methods: This was a prospective, observational study conducted from January 2019 to March 2020. All consecutive O group donors were included. All samples were tested by conventional tube technique (CTT). Demographic and anthropometric details of the donors such as gender, age, religion, height, weight, first-time/repeat donor, and state of residence were recorded. The high-titer group included individuals with anti-A and anti-B ≥128, and the low-titer group included individuals with anti-A and anti-B <128. Results: A total of 2000 Group O whole blood donors were included. A higher percentage of donors were older than 30 years of age (55.3%), males (90.7%), Hindu (87.15%), belonging to Uttar Pradesh (70.85%), height more than 160 cm (88.85%), weight more than 65 kg (82.2%), body mass index (BMI) more than 23 (86.15%), body surface area more than 1.7 m2 (89.95%), and first-time donors (68.4%). The donor age, height, weight, BMI, and body surface area were found to have a weak correlation with anti-A and anti-B titers performed by CTT. The correlation between female and male gender was poor in high-as well as low-titer category. Conclusion: A definite variation in antibody titers is seen with a change in donor demographics and anthropometrics. However, none of the variables helps as a screening tool for identifying the North Indian healthy donors who possess a high or low titer. [ABSTRACT FROM AUTHOR]

Background and Aims: When determining ABO antibody titers, IgG antibodies can be masked by immunoglobulin M (IgM) antibodies. Hence, the measurement of actual concentration of IgG requires methods such as heat inactivation (HI) of plasma. This study was aimed at determining the effects of HI on IgM and IgG titers performed by conventional test tube (CTT) technique and column agglutination technique (CAT). Materials and Methods: This was a prospective, observational study conducted from October 2018 to March 2020. All consecutive O group donors who gave consent for participation were included in the study. All samples were consecutively tested by CTT and CAT, before and after HI (pCTT and pCAT). Results: A total of 2005 donors were included. IgG titers were found to be more than IgM titers. pCTT IgG results are similar or lower when compared to results obtained by solid-phase red cell adherence (SPRCA), whereas pCAT IgG titers were higher with pCAT when compared to hemagglutination (HA)/SPRCA. The results of titers obtained by pCTT were lower as compared to pCAT and HA/SPRCA, with majority giving results <64. The median IgG and IgM titers for both anti-A and anti-B were highest in pCAT, whereas the median IgG and IgM anti-A and anti-B titers were similar to HA and pCTT. Conclusion: Results obtained by HA/SPRCA were closer to results obtained by pCTT, with the advantage of less time consumption, automation requiring less expertise, and no interobserver variation. Titers obtained by pCAT were higher in comparison to HA/SPRCA and pCTT results, due to high sensitivity. [ABSTRACT FROM AUTHOR]

Background and aims: In order to determine actual concentration of clinically significant IgG antibodies, there is a need to inactivate IgM antibodies, which can be performed by DTT or heat. The aim of the present study was to compare the effect of DTT treatment and heat inactivation (HI) on ABO isoagglutinin titres performed by column agglutination technology (CAT) and conventional tube technique (CTT). Materials and methods: This was a prospective, observational study conducted from October 2018 to March 2020. All consecutive O group donors were included. Serum from each donor was treated with DTT, and heat and tests were performed by CTT and CAT before and after treatment. Results: A total of 2005 donors were included. 401 (20%) samples had inter‐observer variation by CTT, and 69 (3·4%) had inter‐observer variation by CAT. Median anti‐A and anti‐B titre results were higher with CAT as compared to CTT. Median anti‐A and anti‐B IgG titre results showed a one‐ to twofold difference between CTT and CAT with higher titres reported by CAT. Median IgM titres decreased two‐ to threefold after DTT treatment, whereas onefold decrease was confirmed after HI. Concordance was found to be poor. However, correlation was found to be strong. Conclusion: There is overestimation of ABO IgG antibody titres and hence, estimation of ABO IgG titres after inactivation of IgM antibodies is strongly recommended. DTT treatment was found to be superior to HI in terms of efficiency in elimination of IgM activity. [ABSTRACT FROM AUTHOR]