Mark H. Yazer, Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA Vitalant, Pittsburgh, Pennsylvania, USA
Philip C. Spinella, Blood Systems Research Institute and University of California, San Francisco, California, USA
Leilani Doyle, the Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Ontario, Canada (L.D.) Canadian Field Hospital, Canadian Armed Forces, Ottawa, Ontario, Canada (L.D.
Richard M. Kaufman, the Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (R.M.K.)
Robyn Dunn, he Wing-Kwai and Alice Lee-Tsing Chung Transfusion Service, Department of Pathology and Laboratory Medicine, UCLA Health, Los Angeles, California (R.D., A.Z.
John R. Hess, Department of Laboratory Medicine and Pathology, Seattle, Washington, USA
Luiz Amorim Filho, emorio, Rio de Janeiro, Brazil (L.A.F.)
Magali Fontaine, Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA
Birgit Gathof, Institute of Transfusion Medicine, University of Cologne, University Hospital, Cologne, Germany (B.G.
Bryon Jackson, Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (B.J.)
Michael F Murphy, NHS Blood & Transplant and Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
Jeremiah Pasion, Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland (M.F., J.P.)
Jay S. Raval, Department of Pathology, University of New Mexico, Albuquerque, New Mexico (J.S.R.).
Kristin Rosinski, the Vancouver Coastal Health Authority, Vancouver, British Columbia, Canada (K.R
Jansen Seheult, Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA
Andrew W. Shih, Department of Pathology and Laboratory Medicine, Vancouver General Hospital, Vancouver, British Columbia, Canada
Jason Sperry, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USADepartment of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
Julie Staves, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
Erin E. Tuott, Department of Laboratory Medicine and Pathology, Seattle, Washington, USA
Alyssa Ziman, Wing-Kwai and Alice Lee-Tsing Chung Transfusion Service, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, UCLA (University of California, Los Angeles), Los Angeles, California, USA
Darrell J. Triulzi, rom Vitalant, Pittsburgh, Pennsylvania (M.H.Y., D.J.T.) the Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania (M.H.Y., D.J.T.

Document Type

Article

Publication Date

3-1-2020

Abstract

BACKGROUND: Group O erythrocytes and/or whole blood are used for urgent transfusions in patients of unknown blood type. This study investigated the impact of transfusing increasing numbers of uncrossmatched type O products on the recipient's first in-hospital ABO type.

METHODS: This was a retrospective cohort study. Results of the first ABO type obtained in adult, non-type O recipients (i.e., types A, B, AB) after receiving at least one unit of uncrossmatched type O erythrocyte-containing product(s) for any bleeding etiology were analyzed along with the number of uncrossmatched type O erythrocyte-containing products administered in the prehospital and/or in hospital setting before the first type and screen sample was drawn.

RESULTS: There were 10 institutions that contributed a total of 695 patient records. Among patients who received up to 10 uncrossmatched type O erythrocyte-containing products, the median A antigen agglutination strength in A and AB individuals on forward typing (i.e., testing the recipient's erythrocytes for A and/or B antigens) was the maximum (4+), whereas the median B antigen agglutination strength among B and AB recipients of up to 10 units was 3 to 4+. The median agglutination strength on the reverse type (i.e., testing the recipient's plasma for corresponding anti-A and -B antibodies) was very strong, between 3 and 4+, for recipients of up to 10 units of uncrossmatched erythrocyte-containing products. Overall, the ABO type of 665 of 695 (95.7%; 95% CI, 93.9 to 97.0%) of these patients could be accurately determined on the first type and screen sample obtained after transfusion of uncrossmatched type O erythrocyte-containing products.

CONCLUSIONS: The transfusion of smaller quantities of uncrossmatched type O erythrocyte-containing products, in particular up to 10 units, does not usually interfere with determining the recipient's ABO type. The early collection of a type and screen sample is important.

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