High titre anti-A/B testing of donors

[henribeau]

I need to determine the unsafe endpoint of a manual tube room temp titre to prevent hemolytic reactions for receipient of ABO incompatible Pooled Plt or ABO incompatible Apheresis plts. I've seen several different titres (1/50, 1/100, 1/200 and 1/256) but I do not want to exclude safe donors. Is anyone performing these at their facility. thx

[scodina]

We are in the process of implementing this testing. We are only testing group O platelets. We plan to use a dilution of 1:100 againt a and b cells in an IgG gel card. If the reaction is positive, the platelets can only be used for type O recipients. Those platelets that are negative can be issued to any type recipient. We chose the 1:100 dilution based on a cont ed program I attended that stated this is the European standard.

Stephanie

[PaulSunV]

I am interested in the titer approach to incompatible plasma and would be interested in any references you can provide. With platelets being in short supply on a regular basis what do you do if there aren’t any type specific platelets available and all you have is a high titer product.

We have a policy relating to incompatible plasma and a limit that we have placed upon it based upon volume. “No patient shall receive more that 1000 mls of incompatible plasma per 7-day period or approximately 600 mls per 24-hour period unless approved by the pathologist on call.”

[JWCHB'HAM]

We use the 1:50 titer. It has worked well for years. 1 drop plasma to 49 drops of saline. Test 2 drops against 1 drop of A1 or B cells at IS. It is quick and easy.

[henribeau]

We are in the process of implementing this testing. We are only testing group O platelets. We plan to use a dilution of 1:100 againt a and b cells in an IgG gel card. If the reaction is positive, the platelets can only be used for type O recipients. Those platelets that are negative can be issued to any type recipient. We chose the 1:100 dilution based on a cont ed program I attended that stated this is the European standard.

Stephanie

do you know the european standard? I would like to reference it in my COP. Thanks again for you help. We do mostly manual work so I may adopt a Peg IAT instead of gel-does this make sense?

[henribeau]

I am interested in the titer approach to incompatible plasma and would be interested in any references you can provide. With platelets being in short supply on a regular basis what do you do if there aren’t any type specific platelets available and all you have is a high titer product.

We have a policy relating to incompatible plasma and a limit that we have placed upon it based upon volume. “No patient shall receive more that 1000 mls of incompatible plasma per 7-day period or approximately 600 mls per 24-hour period unless approved by the pathologist on call.â€

We are deveoloping a policy for incompatible plts/we call med director if incompatible plasma is required-we don't have plasma supply problem. We do not titre plts but are now pooling plts using buffy coat poor methods and our pooled plts were a pool of 5 donors plasma(we would plasma reduce apheresis plts) but now the pool is 80% one donor and 20% 3 other donors. Now we are having problems with any incompatible plt issue.

[henribeau]

We use the 1:50 titer. It has worked well for years. 1 drop plasma to 49 drops of saline. Test 2 drops against 1 drop of A1 or B cells at IS. It is quick and easy.

do you have a standard or method(paper) that you reference for this dilution?

[JWCHB'HAM]

They have been doing it this way for many years (I have been here for 2). I will check and get back to you.