ABO‑Incompatible Plasma Transfusion: Risks and Management

Risk in Pediatric Patients

Pediatric patients have a markedly higher risk of clinically significant hemolysis when transfused with ABO‑incompatible plasma, especially with larger plasma volumes. 1

Plasma that contains donor anti‑A or anti‑B antibodies can trigger acute hemolytic reactions during or shortly after transfusion, producing morbidity that is generally less severe than that seen with ABO‑incompatible red‑cell transfusions. 1

Providing ABO‑compatible plasma products whenever they are available completely eliminates the hemolysis risk associated with ABO incompatibility. 1

If ABO‑compatible plasma is unavailable and incompatible plasma must be administered, close clinical monitoring for hemolysis is required. 1

Inkompatibilitas ABO dapat mengurangi increment trombosit pasca-transfusi, seperti yang terjadi pada transfusi trombosit golongan A untuk resipien golongan O 2, 3
Risiko hemolisis dari plasma yang tidak kompatibel dalam produk trombosit dapat menyebabkan hemolisis, terutama pada anak-anak 3
Pentingnya kompatibilitas ABO dalam menilai refraktori: saat mendiagnosis refraktori trombosit, harus menggunakan setidaknya dua transfusi yang kompatibel ABO untuk secara akurat menilai apakah increment yang buruk disebabkan oleh aloimunisasi versus ketidakcocokan ABO 2, 3

The American Society of Hematology recommends considering ABO incompatibility in hematopoietic stem cell transplantation, as it may lead to hemolytic reactions and delayed engraftment 2