Table 3.
Transfusion strategy
| ABO mismatch | Recipient | Donor | RBC support from start of conditioning regimen | Plateletsb and plasma |
|---|---|---|---|---|
| Major | O | A | Oa | A, AB |
| O | B | Oa | B, AB | |
| O | AB | Oa | AB | |
| A | AB | A, Oa | AB | |
| B | AB | B, Oa | AB | |
| Minor | A | O | O | A, AB |
| B | O | O | B, AB | |
| AB | O | O | AB | |
| AB | A | A, O | AB | |
| AB | B | B, O | AB | |
| Bi-directional | A | B | Oa | AB |
| B | A | Oa | AB | |
| Rhesus D mismatch | Recipient | Donor | RBC and platelet support from start of conditioning regimen | RBC and platelet support after HSCT |
| Rh D | positive | negative | positive | negative |
| negative | positive | negative | positive | |
a
Group O RBC until anti-donor isohemagglutinins are undetectable, additionally RBCs of donor type blood group should be present while signs of relapse or graft failure are absent, then switch to donor blood group.
b
First choice for platelet support given. Platelets stored in additive solution reduce the volume of incompatible plasma. Otherwise ABO-incompatible platelet components should be plasma reduced.