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Education Session

Clinical Transfusion & Patient Care

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

AM26-MO-04-L - 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

Monday, October 19, 2026
8:15 AM - 9:15 AM EST
Room: GWCC B401-402

    Program Chair(s)

  • Colleen Gilstad, MD

    Medical Director Transfusion Service
    MedStar Georgetown University Hospital
    Washington, District of Columbia

    Disclosure(s): No relevant disclosure to display.

    • Speaker(s)

  • Majed Rafaai, MD

    Professor, Pathology and Laboratory Medicine
    University of Rochester Medical Center
    Rochester, New York

    Disclosure(s): No relevant disclosure to display.

  • Martin Ongkeko, MD

    Medical Director, Blood Bank
    Washingon Hospital Center, Georgetown University
    Washington, District of Columbia

    Disclosure(s): No financial relationships to disclose.

Disclosure(s):
Colleen Gilstad, MD: No relevant disclosure to display.
Majed Rafaai, MD: No relevant disclosure to display.
Martin Ongkeko, MD: No financial relationships to disclose.
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.

Learning Objectives:

  • Understand some basic principles of the ABO blood groups and relevance to immune effects of transfusions
  • Identify blood group B component association with some severe anaphylactic transfusion reactions and alpha gal syndrome.
  • Compare the benefits and difficulties of three different strategies that have been implemented and can be expected to prevent severe allergic reactions related to alpha gal syndrome.
  • Be able to create a mitigation strategy, as appropriate for local circumstances.