Transfusion medicine handbook

4. Blood Components

4.2 Avoiding ABO Incompatible Transfusions

Safe transfusion depends on avoiding ABO incompatibility between the patient and transfused blood components, either between donor red cells and the patient’s ABO antibodies or conversely donor plasma ABO antibodies and the patient’s red cells.

Red cells of the same ABO group, i.e., ABO identical, as the patient should normally be selected. Only when these are unavailable should alternative ABO compatible red cells be selected (see Table 4.10: ABO Compatibility for Red Cell Components ). In life-threatening situations, where a confirmed blood group for the patient is not available, group O red cells should be given. Group O donations identified as emergency units have low levels of anti-A and anti-B to avoid potential sensitisation and destruction of the patient’s red cells (in non-group O recipients).

Platelet concentrates should ideally be ABO identical or alternatively ABO compatible with the patient's red cells (see Table 4.12: ABO Compatibility for Platelet Components). This is however not a strict requirement and due to logistics or supply issues, platelets with a different ABO group may be supplied in clinically urgent situations following consultation with an NZBS Transfusion Medicine Specialist / Medical Officer. Additional pretransfusion testing is not required for platelets.

Fresh frozen plasma and cryoprecipitate should be ABO compatible with the patient's red cells (see Table 4.15: ABO Compatibility of Fresh Frozen Plasma and Cryoprecipitate). Additional pretransfusion testing is not required for FFP and cryoprecipitate.