Cite this article as:
Anders, M. ABO incompatible blood transfusion, Don't Forget the Bubbles, 2013. Available at: http://doi.org/10.31440/DFTB.3786
UNOS Policy: ABO incompatible HTX for children up to 2 years (with acceptable isohaemoglutinin titres – less than 1:4)
Recipient
Donor compatible
Donor incompatible
Antibodies to avoid
Plasma / Platelets
RBC
0
0
0
0
AB
Anti AAnti B
AB
0
0
A
Anti A
AB or A
0
0
B
Anti B
AB or B
0
A
A
A
0
A
AB
Anti AAnti B
AB
A or 0
A
B
Anti AAnti B
AB
A or 0
B
B
B
0
B
AB
Anti AAnti B
AB
B or 0
B
A
Anti AAnti B
AB
B or 0
AB
AB
AB
AB
A
AB
AB
B
AB
AB
0
AB
Preoperative preparation:
Isohaemagglutinin titres. Avoid transfusion. Consider transfusion in regards to guide.
Perioperative management:
If elevated iso-titre: plasma exchange once on CPB, iso-haemagglutinin quick test before AoCx release, repeat plasma exchange as required.
Postoperative management:
Isohaemaggluttinin titres daily of ABOi HTX. Repeat plasma exchange if required.
Outcome:
Similar long term outcome. Reduced rate of infection and rejection compared to ABO compatible blood transfusions.
References:
[1] Paediatric Heart Transplant Society: www.uab.edu/phts/
[2] Heart Lung Transplant. 2012 Feb;31(2):173-9: Henderson et al: ABO-incompatible heart transplantation: analysis of the Pediatric Heart Transplant Study (PHTS) database.
All Marc’s PICU cardiology FOAM can be found on PICU Doctor and can be downloaded as a handy app for free on iPhone or Android. A list of contributors can be seen here.
ABO incompatible blood transfusion
Tags: blood transfusion, incompatible, packed cells
Anders, M. ABO incompatible blood transfusion, Don't Forget the Bubbles, 2013. Available at:
http://doi.org/10.31440/DFTB.3786
UNOS Policy: ABO incompatible HTX for children up to 2 years (with acceptable isohaemoglutinin titres – less than 1:4)
Preoperative preparation:
Isohaemagglutinin titres. Avoid transfusion. Consider transfusion in regards to guide.
Perioperative management:
If elevated iso-titre: plasma exchange once on CPB, iso-haemagglutinin quick test before AoCx release, repeat plasma exchange as required.
Postoperative management:
Isohaemaggluttinin titres daily of ABOi HTX. Repeat plasma exchange if required.
Outcome:
Similar long term outcome. Reduced rate of infection and rejection compared to ABO compatible blood transfusions.
References:
[1] Paediatric Heart Transplant Society: www.uab.edu/phts/ [2] Heart Lung Transplant. 2012 Feb;31(2):173-9: Henderson et al: ABO-incompatible heart transplantation: analysis of the Pediatric Heart Transplant Study (PHTS) database.All Marc’s PICU cardiology FOAM can be found on PICU Doctor and can be downloaded as a handy app for free on iPhone or Android. A list of contributors can be seen here.
About Marc Anders
Marc Anders is a paediatric intensivist.