Reduction of anti-A and anti-B isoagglutinin titers of group O whole blood units employing an ABO antibody immune adsorption column

Gaurav K Gupta; Kelly Henrichs; Kurt Nilsson; Stephen Wagner; Bethany Brown; Debra Masel; Mark L Gestring; Michael A Vella; Majed A Refaai; Neil Blumberg

doi:10.1016/j.transci.2023.103686

Reduction of anti-A and anti-B isoagglutinin titers of group O whole blood units employing an ABO antibody immune adsorption column

Transfus Apher Sci. 2023 Jun;62(3):103686. doi: 10.1016/j.transci.2023.103686. Epub 2023 Mar 5.

Authors

Affiliations

¹ Transfusion Medicine/Blood Bank, Department of Pathology and Laboratory Medicine, University of Rochester, Rochester, NY, USA. Electronic address: guptag2@mskcc.org.
² Transfusion Medicine/Blood Bank, Department of Pathology and Laboratory Medicine, University of Rochester, Rochester, NY, USA. Electronic address: Kelly_Henrichs@URMC.Rochester.edu.
³ Glycorex Transplantation AB, Section of Hematology, Lund, Sweden. Electronic address: jn@glycorex.se.
⁴ American Red Cross Holland Laboratory, Rockville, MD, USA. Electronic address: wagstalbot@yahoo.com.
⁵ American Red Cross Holland Laboratory, Rockville, MD, USA. Electronic address: bethany.brown2@redcross.org.
⁶ Transfusion Medicine/Blood Bank, Department of Pathology and Laboratory Medicine, University of Rochester, Rochester, NY, USA. Electronic address: Debra_Masel@URMC.Rochester.edu.
⁷ Acute Care Surgery and Trauma, Department of Surgery, University of Rochester, Rochester, NY, USA. Electronic address: Mark_Gestring@urmc.rochester.edu.
⁸ Acute Care Surgery and Trauma, Department of Surgery, University of Rochester, Rochester, NY, USA. Electronic address: Michael_Vella@urmc.rochester.edu.
⁹ Transfusion Medicine/Blood Bank, Department of Pathology and Laboratory Medicine, University of Rochester, Rochester, NY, USA. Electronic address: Majed_Refaai@URMC.Rochester.edu.
¹⁰ Transfusion Medicine/Blood Bank, Department of Pathology and Laboratory Medicine, University of Rochester, Rochester, NY, USA. Electronic address: Neil_Blumberg@URMC.Rochester.edu.

PMID: 36894466
DOI: 10.1016/j.transci.2023.103686

Abstract

Background: Massive hemorrhage is a leading cause of death from trauma. There is growing interest in group O whole blood transfusions to mitigate coagulopathy and hemorrhagic shock. Insufficient availability of low-titer group O whole blood is a barrier to routine use. We tested the efficacy of the Glycosorb® ABO immunoadsorption column to reduce anti-A/B titers in group O whole blood.

Methods: Six group O whole blood units were collected from healthy volunteers, and centrifuged to separate platelet poor plasma. Platelet-poor plasma was filtered through a Glycosorb® ABO antibody immunoabsorption column, then reconstituted to prepare post-filtration whole blood. Anti-A/B titers, CBC, free hemoglobin, and thromboelastography (TEG) assays were performed on pre-and post-filtration whole blood.

Results: Mean( ± SEM) anti-A (224 ± 65 pre vs 13 ± 4 post) and anti-B (138 ± 38 pre vs 11 ± 4 post) titers were significantly reduced (p = 0.004) in post-filtration whole blood. No significant changes were detected in CBC, free hemoglobin, and TEG parameters on day 0. Free hemoglobin increased throughout storage (48 mg/dl ± 24 Day 0 vs 73 ± 35 Day 7 vs 96 ± 44 Day 14; p = 0.14).

Conclusions: The Glycosorb® ABO column can significantly reduce anti-A/B isoagglutinin titers of group O whole blood units. Glycosorb® ABO could be employed to provide whole blood with lower risk of hemolysis and other consequences of infusing ABO incompatible plasma. Preparation of group O whole blood with substantially reduced anti-A/B would also increase the supply of low-titer group O whole blood for transfusion.

Keywords: ABO blood group; Immunoadsorption; Massive transfusion; Whole blood.

MeSH terms

ABO Blood-Group System
Adsorption
Antibodies*
Blood Group Incompatibility
Hemagglutinins*
Humans

Substances

Antibodies
Hemagglutinins
ABO Blood-Group System