Table 4.

Summary of platelet minor ABO incompatibility risk-mitigation strategies

Mitigation strategy	Drawbacks
Issue only ABO identical or compatible units	Identical or compatible units may not always be available in inventoryPotential for increased outdate rates
Limit volume of incompatible plasma	Compatible units may not always be available in inventoryPotential for increased outdate rates
Provide pooled whole blood–derived platelets	Pooled platelets are not widely available in the United StatesHemolytic transfusion reactions have been reported in pooled platelet units
Provide units suspended in PAS	PAS platelets are not widely available in the United StatesHemolytic transfusion reactions have been reported in PAS units
Provide low-titer units	Titer method is not standardizedNo agreed upon high-titer cutoffSubstantial percentage of group O units may be high titer, depending on cutoffSaline titer methods may miss units with high-titer IgG antibodiesHemolytic transfusion reactions have been reported in low-titer units
Volume reduction	Shortens shelf lifeDecreases platelet contentIncreases the time required for unit preparation and blood bank workloadNot feasible for emergency transfusions
Washing	Shortens shelf lifeDecreases platelet contentIncreases the time required for unit preparation and blood bank workloadNot feasible for emergency transfusions

IgG, immunoglobulin G; PAS, platelet additive solution.