Dangerous universal donors: the reality of the Hemocentro in Belo Horizonte, Minas Gerais

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• 作者：Mariana Martins Godin^a ; ^b ; Lucas de Oliveira Souza^b ; Luciana Cayres Schmidt^b ; Lauro Mello Vieira^a ; Rejane Silva Diniz^a ; Luci Maria SantAna Dusse^a ; ^{lucidusse@gmail.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Hemagglutinins ; IgM ; IgG ; Dangerous universal donor ; Hemolytic transfusion reaction
• 刊名：Revista Brasileira de Hematologia e Hemoterapia
• 出版年：2016
• 出版时间：July-September 2016
• 年：2016
• 卷：38
• 期：3
• 页码：193-198
• 全文大小：728 K

文摘

The term dangerous universal blood donor refers to potential agglutination of the erythrocytes of non-O recipients due to plasma of an O blood group donor, which contains high titers of anti-A and/or anti-B hemagglutinins. Thus, prior titration of anti-A and anti-B hemagglutinins is recommended to prevent transfusion reactions.

Objective

The aim of this study was to estimate the frequency of dangerous universal donors in the blood bank of Belo Horizonte (Fundação Central de Imuno-Hematologia – Fundação Hemominas – Minas Gerais) by determining the titers of anti-A and anti-B hemagglutinins in O blood group donors.

Method

A total of 400 O blood group donors were randomly selected, from March 2014 to January 2015. The titers of anti-A and anti-B hemagglutinins (IgM and IgG classes) were obtained using the tube titration technique. Dangerous donors were those whose titers of anti-A or anti-B IgM were ≥128 and/or the titers of anti-A or anti-B IgG were ≥256. Donors were characterized according to gender, age and ethnicity. The hemagglutinins were characterized by specificity (anti-A and anti-B) and antibody class (IgG and IgM).

Results

Almost one-third (30.5%) of the O blood group donors were universal dangerous. The frequency among women was higher than that of men (p-value = 0.019; odds ratio: 1.66; 95% confidence interval: 1.08–2.56) and among young donors (18–29 years old) it was higher than for donors between 49 and 59 years old (p-value = 0.015; odds ratio: 3.05; 95% confidence interval: 1.22–7.69). There was no significant association between dangerous universal donors and ethnicity, agglutinin specificity or antibody class.

Conclusion

Especially platelet concentrates obtained by apheresis (that contain a substantial volume of plasma), coming from dangerous universal donors should be transfused in isogroup recipients whenever possible in order to prevent the occurrence of transfusion reactions.