Platelet Additive Solutions as an Alternative Storage Medium of Apheresis Platelets to Reduce ABO Antibody Titer for ABO-Incompatibility Platelet Transfusion

Sumaiyah Adzahar; Mohd Nazri Hassan; Zefarina Zulkafli; Noor Haslina Mohd Noor; Marini Ramli; Shafini Mohamed Yusoff; Sien Tzi Lam; Rajesh Deshpande; Wan Zaidah Abdullah

doi:10.7759/cureus.44012

Platelet Additive Solutions as an Alternative Storage Medium of Apheresis Platelets to Reduce ABO Antibody Titer for ABO-Incompatibility Platelet Transfusion

Cureus. 2023 Aug 23;15(8):e44012. doi: 10.7759/cureus.44012. eCollection 2023 Aug.

Authors

Sumaiyah Adzahar¹, Mohd Nazri Hassan², Zefarina Zulkafli², Noor Haslina Mohd Noor², Marini Ramli², Shafini Mohamed Yusoff², Sien Tzi Lam³, Rajesh Deshpande³, Wan Zaidah Abdullah²

Affiliations

¹ Department of Pathology, Faculty of Medicine, Universiti Sultan Zainal Abidin (UniSZA), Terengganu, MYS.
² Department of Hematology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, MYS.
³ Fresenius, Kabi, Kuala Lumpur, MYS.

Abstract

Introduction Platelet additive solutions (PASs) are nutrient media commonly used to replace and reduce the need for storage plasma. They are an alternative medium to maintain high-quality platelets lasting longer on the shelf for about seven days. Platelets with high titer of ABO antibody can pose a hemolytic transfusion reaction (HTR) risk if units are given across the ABO barrier. The risk of complication is greater when group O platelet is released to non-group O patients. The PAS has been known as a safe medium, where the titer of ABO antibodies is expected to be diluted. In this study, we compared the anti-A and anti-B antibody titers of apheresis platelets in PAS and non-PAS (plasma) as the suspending media. Methods A total of 20 apheresis platelet donors were selected, with seven from blood group A, eight from blood group B, and five from blood group O. The platelets were collected using an Amicus cell separator. They were suspended in PAS and plasma before being stored at a temperature range of 22-24^ºC. Anti-A (blood group B and O) and Anti-B (blood group A and O) antibody titers were measured and compared between the two suspending media. Wilcoxon signed-rank test is used for statistical analysis, and a p-value <0.05 is considered significant. Results The median titer of the anti-A antibody of apheresis platelets showed a significant difference between suspended in PAS (2.50) and plasma (4.00), p=0.002. Similar findings were also seen with the median titer of the anti-B antibody of apheresis platelet, in which it showed a significant difference between suspended in PAS (2.00) and plasma (4.00), p=0.004. It was observed that there was a significant reduction in both anti-A and anti-B antibody titers in the PAS as compared to the plasma group. Conclusion The decrease in ABO antibody titer in apheresis platelets stored with PAS can be beneficial for patients. This reduces the risk of HTRs if ABO-incompatible platelet units need to be issued. Thus, using PAS as a storage medium significantly improves platelet inventory management without compromising patient safety.

Keywords: antibody titer; apheresis platelet; htr; pas; platelet transfusion.

Grants and funding

This work was funded by a GPSP grant (1001/PPSP/8070011) awarded by Universiti Sains Malaysia.