Strict ABO Plasma/platelet Matching versus Selective Group AB and B Component Avoidance to Avoid Anaphylactic Transfusion Reactions Due to Alpha Gal Syndrome: The Experience of 3 Hospitals

Proposed Session Description: Medical Directors from three hospitals will present their experience with different avoidance strategies for transfusion related alpha gal syndrome. Since the reported serious reactions have mainly been due to the transfusion of group B Platelets and Plasma to group O recipients, the avoidance of transfusing group B components to group O recipients can be expected to prevent reactions. One option would be to implement strict ABO matching, which potentially has additional clinical benefits besides complete avoidance ABO related anaphylactic transfusion reactions. The rational and multi-year experience of this strategy at University of Rochester Medical Center will be presented. The experience of Medstar Washington Hospital Center and Medstar Georgetown University Hospital managing multiple cases of anaphylactic transfusion reactions to group B and A components in group O recipients, many previously unreported, will then be presented. This resulted in the instituting of selective group B avoidance after multiple cases were associated with IgE to alpha gal. This strategy included the use of implementing medical chart information alerts, but also different degrees of individual pre-transfusion patient assessments, as one site had on-call pathology residents available to do recipient screening and one did not.