Has anyone started doing titers on platelets pheresis products before issuing out of group platelets to patients? If so, could you share your process? Our blood supplier has no immediated plans to supply titer results on products.

I find that titering plts is an interesting conundrum . . . I can only get group O or gorup A plts (apheresis packs). Fortunately, we do not do infants but even if I did, once I get the plt, unless it is defective, there is no way the blood center is going to take it back . . . I know some places do a 1:50 dilution which, if it reacts greater than 1+, will not be given out of group.

we have this process in place for a while now(i think 2006). We do not give ABO incompatible platelets to neonates.

Adult we titer it and if titer is <64 (RT) then we give it. Our supplier do not provide titer result/do nto perform anti-A/anti-B titer.

We only use aphresis platelets.

We do the same as aakupaku - started this 2 years ago after a hemolytic reaction:

-- myelodysplastic patient group A received group O -- started issuing incompatible if titre <64, a year later we thought a low titre group O would be fine for him but turned out he has PNH so his cells were already complement coated + the Anti-A = crisis. There was a poster at AABB this past year - I'll try to post it here.

A transfusion physician commented he doesn't really agree with titres, feels patients like ours are a 'one off', some will react to low titres too (seems to be the case this time!)

I now think twice about the myelodysplastic patients receiving incompatible groups - we try to stock mainly A to be compatible with majority but still titre if incompatible

We do the same as aakupaku - started this 2 years ago after a hemolytic reaction:

-- myelodysplastic patient group A received group O -- started issuing incompatible if titre <64, a year later we thought a low titre group O would be fine for him but turned out he has PNH so his cells were already complement coated + the Anti-A = crisis. There was a poster at AABB this past year - I'll try to post it here.

A transfusion physician commented he doesn't really agree with titres, feels patients like ours are a 'one off', some will react to low titres too (seems to be the case this time!)

I now think twice about the myelodysplastic patients receiving incompatible groups - we try to stock mainly A to be compatible with majority but still titre if incompatible

janet, I think your post is so important. The PNH patient is sensitive to complement, so the low titer anti-A will cause the crisis. Would this kind of condition occur on AIHA patient ? This is also an interesting question need we to investigate.