Evaluation of an
ABO
antibody immunoadsorption column for reduction of anti‐A and anti‐B isoagglutinin titers in group O platelet units
Melanie J. Robbins, Susan Proffitt, Gillian Eastwood, Sian Huish, Kurt Nilsson, Rebecca Cardigan Abstract
Background
Clinical guidelines recommend transfusing ABO‐identical platelets where possible. However, the short shelf life of platelets (5–7 days) and stock availability mean ABO‐nonidentical platelet transfusions are sometimes unavoidable. Minor ABO‐incompatible platelet transfusions carry a risk of hemolysis due to donor anti‐A/B antibodies, and high‐titer (HT)‐negative units are preferred to mitigate this risk. To further mitigate this risk, we investigated whether an ABO antibody immunoadsorption column could reduce anti‐A/B titers in group O platelet units while preserving platelet quality.
Study Design and Methods
Six group O double dose apheresis platelet units were pooled with HT‐positive group O plasma and split into three arms: untreated control, single‐pass filtration (Glycosorb ABO A/B‐column), and double‐pass using the same column. Anti A and anti B IgM and IgG titers were measured pre‐ and post‐filtration using a gel card method. Platelet count, platelet volume, coagulation factors, and markers of platelet quality and activation were assessed after filtration and during storage.
Results
Anti‐A and anti‐B titers were decreased from titers of 128 to ≤4 (IgM) and from 512 to ≤8 (IgG) following a single pass through the immunoadsorption column. Reduced efficacy was observed following a second pass through the same column (≤32 (IgM) and ≤128 (IgG)). Filtration was not associated with substantial platelet loss, although changes in some metabolic and activation markers were observed during storage.
Discussion
The ABO antibody immunoadsorption column effectively reduced anti‐A/B titers in group O platelet units and may offer a strategy to increase the availability of low‐titer platelets for transfusion.