Transfusion Medicine/Blood Bank, Department of Pathology and Laboratory Medicine, University of Rochester, Rochester, NY, USA.
Glycorex Transplantation AB, Section of Hematology, Lund, Sweden.
Transfus Apher Sci. 2023 Jun;62(3):103686. doi: 10.1016/j.transci.2023.103686. Epub 2023 Mar 5.
Massive hemorrhage is a leading cause of death from trauma. There is growing interest in group O whole blood transfusions to mitigate coagulopathy and hemorrhagic shock. Insufficient availability of low-titer group O whole blood is a barrier to routine use. We tested the efficacy of the Glycosorb® ABO immunoadsorption column to reduce anti-A/B titers in group O whole blood.
Six group O whole blood units were collected from healthy volunteers, and centrifuged to separate platelet poor plasma. Platelet-poor plasma was filtered through a Glycosorb® ABO antibody immunoabsorption column, then reconstituted to prepare post-filtration whole blood. Anti-A/B titers, CBC, free hemoglobin, and thromboelastography (TEG) assays were performed on pre-and post-filtration whole blood.
Mean( ± SEM) anti-A (224 ± 65 pre vs 13 ± 4 post) and anti-B (138 ± 38 pre vs 11 ± 4 post) titers were significantly reduced (p = 0.004) in post-filtration whole blood. No significant changes were detected in CBC, free hemoglobin, and TEG parameters on day 0. Free hemoglobin increased throughout storage (48 mg/dl ± 24 Day 0 vs 73 ± 35 Day 7 vs 96 ± 44 Day 14; p = 0.14).
The Glycosorb® ABO column can significantly reduce anti-A/B isoagglutinin titers of group O whole blood units. Glycosorb® ABO could be employed to provide whole blood with lower risk of hemolysis and other consequences of infusing ABO incompatible plasma. Preparation of group O whole blood with substantially reduced anti-A/B would also increase the supply of low-titer group O whole blood for transfusion.
大出血是创伤导致死亡的主要原因。人们对 O 型全血输注以减轻凝血功能障碍和出血性休克的兴趣日益浓厚。低滴度 O 型全血供应不足是常规使用的障碍。我们测试了 Glycosorb® ABO 免疫吸附柱降低 O 型全血中抗 A/B 效价的效果。
从健康志愿者中采集 6 个 O 型全血单位，离心分离血小板贫血浆。将血小板贫血浆通过 Glycosorb® ABO 抗体免疫吸附柱过滤，然后再构成过滤后的全血。对过滤前后的全血进行抗 A/B 效价、CBC、游离血红蛋白和血栓弹力图（TEG）检测。
过滤后全血中的平均（± SEM）抗 A（224 ± 65 与 13 ± 4）和抗 B（138 ± 38 与 11 ± 4）效价显著降低（p = 0.004）。CBC、游离血红蛋白和 TEG 参数在第 0 天没有明显变化。游离血红蛋白在整个储存过程中增加（48 mg/dl ± 24 第 0 天与 73 ± 35 第 7 天与 96 ± 44 第 14 天；p = 0.14）。
Glycosorb® ABO 柱可显著降低 O 型全血单位的抗 A/B 同种异体抗体效价。Glycosorb® ABO 可用于提供具有较低溶血风险和输注 ABO 不相容血浆其他后果的全血。制备具有显著降低的抗 A/B 的 O 型全血也将增加低滴度 O 型全血的供应，以用于输血。
