Hi All,

I have a question regarding something which occurred on my nightshift last week - there was a premature baby who required blood products, the baby was a B positive , however we only had group A and group O paediatric cryoprecipitate in stock. The baby had had a pulmonary haemorrhage, on advice from a peer i thawed a group A unit of cryo, however when i tried to issue it through our computer system it wouldnt allow me to due to ABO incomaptibility. From the guidelines i noted that group A was third choice and was really for emergency use in adults. Therefore my question is, is it safe to issue group A cryo to a group B premature neonate?

thanks in advance for any advice

Tricia:confused:

I would be extremely worried about issuing group A cryo to a group B premature baby, unless the cryo is marked as lacking high titre ABO antibodies, and even then would only do so in extremis. This is because premature babies tend to be extremely small, which magnifies the effect of giving incompatible ABO antibodies.

That having been said, I am somewhat surprised that group A cryo is third choice behind group O cryo, on the grounds that ABO antibodies are usually stronger (in terms of both titre and avidity) than those found in group a (and, come to that, group B donors), although this is not universal.

Hi Malcolm,

thanks for that - on our chart 1st choice is group B, second choice is AB and third choice is group A, our chart doesnt give the option for group O, thankfully my gut instinct was not to give the group A cryo and I called my lab manager to confirm what the other peer suggested and she agreed with me that it wasnt the best option - so I ordered down some group B paediatric cryo from our regional transfusion centre and special care was happy to wait for the product coming over!. Was just one of those situations which can only happen at 3am!! however i have learned from it!!

thanks again Malcolm!

tricia