ABO incompatible blood transfusion

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)

RecipientDonor compatibleDonor incompatibleAntibodies to avoidPlasma / PlateletsRBC
000
0ABAnti AAnti BAB0
0AAnti AAB or A0
0BAnti BAB or B0
AA
A0
AABAnti AAnti BABA or 0
ABAnti AAnti BABA or 0
BB
B0
BABAnti AAnti BABB or 0
BAAnti AAnti BABB or 0
ABABAB
ABAAB
ABBAB
AB0AB

 


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.


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About Marc Anders

AvatarMarc Anders is a paediatric intensivist.

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Author: Marc Anders Marc Anders is a paediatric intensivist.

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