Variations in low titer group O whole blood practices in the United States

Abstract

Aims: Blood banking is a strictly monitored industry in the United States (US) with regulatory bodies and accrediting agencies establishing and enforcing standards for the collection, testing, and transfusion of blood products. However, there is a lack of standardization for the increasingly popular blood product low titer group O whole blood (LTOWB). The aims of our survey were to assess the degree of variation in the processes and procedures involved in the collection, manufacture, testing, storage, and transfusion of LTOWB products, which could serve as a resource for establishing future standards. Methods: A survey was written using Qualtrics software. The link to the online survey was sent via email to individuals practicing within blood collection and transfusing facilities in the US. The email addresses were obtained using contact databases from two professional immunohematology and transfusion medicine organizations and one specialist in blood banking (SBB) academic program. Results: A total of 64 responses demonstrates vastly varying practices between facilities among the donor acceptance criteria, antibody titer testing methodology, frequency of donor testing, antibody isotype tested, acceptable titer level, blood component manufacturing process, unit limit per patient, and where and when the units are transfused. Conclusion: The collection and transfusion of LTOWB products continues to increase in the US, but there is notable variability in the manufacture, testing, storage, and transfusion of LTOWB products due to the few defined standards regarding LTOWB including an established acceptable titer threshold. The degree of variation among facilities that collect, test, and transfuse LTOWB is clearly apparent throughout the US.