Abstract：
Background The limited supply of universal plasma has resulted in transfusion of ABO incompatible plasma to patients. As the need to implement whole blood transfusion in pre-hospitals setting rises, the lowest cut-off for anti-A/anti-B that does not cause haemolysis remains unknown. In this first scoping review, we aimed to determine the lowest ABO titre and volume reported in the literature to cause haemolysis from ABO incompatible plasma transfusions (plasma, platelets, cryoprecipitate, and whole blood). Methods We searched several databases from inception to April 2022, including all study types. Three independent reviewers extracted and reviewed the data. Primary outcome was the anti-A and anti-B titre (measured by IgM or IgG) that resulted in measurable haemolysis following ABO incompatible plasma transfusion. Results We identified 5681 citations, of which 49 studies were eligible, reporting a total of 62 cases (34 adults, 14 children and 14 did not specify age). The methods for antibody measurement and antibody type (IgG or IgM) varied significantly between studies. Component volumes were poorly reported. The most common component responsible for the haemolysis was apheresis platelets followed by pooled platelets and whole blood. Most haemolytic cases reported were due to anti-A. The lowest anti-A titre reported to cause haemolysis (children and adults) was 32 (IgG), while for anti-B it was 512 (IgG and IgM) for adults, 16,384 for paediatrics (IgG and IgM) and 128 (IgM) in cases where the age was not specified. The lowest reported volume associated with haemolysis were 100 ml (adults) and 15 ml (children). Of the 62 15 (24%) died. Conclusion The lowest titre reported to cause haemolysis was an anti-A of 32. ABO mismatch plasma transfusion may be associated with significant mortality. There is a need to agree/standardise methods for ABO titration measurement internationally for plasma components and agree the lowest anti-A/anti-B titre for transfusing ABO mismatched plasma.
摘要：
背景通用血浆的有限供应导致向患者输注ABO不相容的血浆。随着在院前设置实施全血输血的需求增加，不引起溶血的抗A/抗B的最低截止值仍然未知.在第一次范围审查中，我们旨在确定文献中报道的最低ABO滴度和体积，以导致ABO不相容的血浆输血引起溶血（血浆，血小板,冷沉淀，和全血）。方法我们从开始到2022年4月检索了几个数据库，包括所有研究类型。三名独立审稿人提取并审查了数据。主要结果是抗A和抗B滴度（通过IgM或IgG测量），导致ABO不相容血浆输注后可测量的溶血。结果我们确定了5681篇引文，其中49项研究符合条件，共报告62例(34例成人，14名儿童和14名没有指定年龄)。抗体测量方法和抗体类型（IgG或IgM）在研究之间差异很大。组件数量报告不佳。引起溶血的最常见成分是单采血小板，然后是合并的血小板和全血。报告的大多数溶血病例是由于抗A。报告的导致溶血（儿童和成人）的最低抗A滴度为32（IgG），而对于抗B，成人为512（IgG和IgM），在未指定年龄的情况下，儿科（IgG和IgM）为16,384和128（IgM）。与溶血相关的最低报告量为100毫升（成人）和15毫升（儿童）。在62人中，有15人（24％）死亡。结论报告的引起溶血的最低滴度是32的抗A。ABO错配血浆输注可能与显著的死亡率相关。需要在国际上就血浆组分的ABO滴定测量的方法达成一致/标准化,并就输注ABO错配血浆的最低抗A/抗B滴度达成一致。
