Low titer group O whole blood in emergency situations

Strandenes, Geir, Berseus, Olle, Cap, Andrew P., Hervig, Toe, Reade, Michael, Prat, Nicolas, Sailliol, Anne, Gonzales, Richard, Simon, Clayton D., Ness, Paul, Doughty, Heidi A., Spinella, Philip C. and Kristoffersen, Einar K. (2014) Low titer group O whole blood in emergency situations. Shock, 41 SUPPL. 1: 70-75. doi:10.1097/SHK.0000000000000150

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Author Strandenes, Geir
Berseus, Olle
Cap, Andrew P.
Hervig, Toe
Reade, Michael
Prat, Nicolas
Sailliol, Anne
Gonzales, Richard
Simon, Clayton D.
Ness, Paul
Doughty, Heidi A.
Spinella, Philip C.
Kristoffersen, Einar K.
Title Low titer group O whole blood in emergency situations
Journal name Shock   Check publisher's open access policy
ISSN 1540-0514
Publication date 2014-05-01
Year available 2014
Sub-type Article (original research)
DOI 10.1097/SHK.0000000000000150
Volume 41
Issue SUPPL. 1
Start page 70
End page 75
Total pages 6
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams & Wilkins
Language eng
Abstract In past and ongoing military conflicts, the use of whole blood (WB) as a resuscitative product to treat trauma-induced shock and coagulopathy has been widely accepted as an alternative when availability of a balanced component-based transfusion strategy is restricted or lacking. In previous military conflicts, ABO group O blood from donors with low titers of anti-A/B blood group antibodies was favored. Now, several policies demand the exclusive use of ABO group-specific WB. In this short review, we argue that the overall risks, dangers, and consequences of "the ABO group-specific approach," in emergencies, make the use of universal group O WB from donors with low titers of anti-A/B safer. Generally, risks with ABO group-specific transfusions are associated with in vivo destruction of the red blood cells transfused. The risk with group O WB is from the plasma transfused to ABO-incompatible patients. In the civilian setting, the risk of clinical hemolytic transfusion reactions (HTRs) due to ABO group-specific red blood cell transfusions is relatively low (approximately 1:80,000), but the consequences are frequently severe. Civilian risk of HTRs due to plasma incompatible transfusions, using titered donors, is approximately 1:120,000 but usually of mild to moderate severity. Emergency settings are often chaotic and resource limited, factors well known to increase the potential for human errors. Using ABO group-specific WB in emergencies may delay treatment because of needed ABO typing, increase the risk of clinical HTRs, and increase the severity of these reactions as well as increase the danger of underresuscitation due to lack of some ABO groups. When the clinical decision has been made to transfuse WB in patients with life-threatening hemorrhagic shock, we recommend the use of group O WB from donors with low anti-A/B titers when logistical constraints preclude the rapid availability of ABO group-specific WB and reliable group matching between donor and recipient is not feasible. Copyright
Keyword Whole blood
ABO - titers
Universal blood
Blood transfusion
Damage control resuscitation
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
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Created: Mon, 04 May 2015, 08:43:00 EST by Matthew Lamb on behalf of School of Medicine