Journal of Blood Disorders & Transfusion

Transfusion of Incompatible ABO Blood Types

Gokul Ram Anand^* Department of Biology, Chettinad Vidyashram, Tamil Nadu, India
^*Correspondence: Gokul Ram Anand, Department of Biology, Chettinad Vidyashram, Tamil Nadu, India, Email:

Received: 17-Nov-2020, Manuscript No. JBDT-24-7169; Editor assigned: 20-Nov-2020, Pre QC No. JBDT-24-7169 (PQ); Reviewed: 04-Dec-2020, QC No. JBDT-24-7169; Revised: 16-Aug-2024, Manuscript No. JBDT-24-7169 (R); Published: 13-Sep-2024, DOI: 10.4172/2155-9864.24.15.603

Introduction

The blood is now collected and passed through a centrifugebased> platform such as the cobe spectra and many more, this> ensures the plasma of the blood is separated and undergoes> plasmapheresis [1]. The specific-antigens are removed in this> procedure and the plasma is sent again through a device that> passes the blood through immunoadsorption to further reduce> the concentration of antibodies in the blood [2].

This can make sure the patient does not become anaemic due to> infections or heavy blood loss (in case of trauma) in the process> of waiting for a blood donor in rare cases such as the Rh-null.> This procedure can be carried out regardless of ABO> incompatibility by suppressing the immune response [3].> Therefore, an O-ve recipient can receive blood from an A+ve> donor, which is a fairly more common blood type.

Description

Every human being is always born with a fixed type of antigens> and antibodies in their blood which determine their blood> group as they age. This is purely the reason why every hospital> has a blood bank with each individual blood type separately> packed with anticoagulants [4]. Some blood types are rarer that> the others and in fact, the Rh-null is called the golden blood for> it is documented to be found only in 40 people worldwide.> When such people encounter severe trauma to their bodies and in turn lose a lot of blood, it could be life threatening, not> because of the trauma, but the inability to find a blood donor.> We could sustain the patient’s body by passing the blood> through a machine in which the it undergoes plasmapheresis to> separate the plasma from the Red Blood Cells (RBCs) and pass> the plasma through a process called immunoadsorption, which is> proven to remove specific antibodies by binding them to specific> proteins and ultimately, removing them from the blood [5]. This> could ensure that the newly transfused blood does not have a> haemolytic-transfusion reaction. By doing this, the patient has> more time to wait for a perfect donor before he becomes anaemic> and his organs start to take damage. When immunoadsorption is> not an option, the patient’s RBCs can be separated from the> plasma and recombined with an AB group blood plasma which> has no antibodies naturally. By doing so, we gradually reduce the> concentration of the antibodies in the blood by following the> procedure on 525 ml (1 pint) of blood per cycle. This has to be> carried on for 9 cycles at the least to ensure the maximum of> antibodies are removed from the plasma of the blood [6].

First and foremost, the patient will be injected with heparin, 25> units/kg through a IV after which the blood would need to be> drawn from the patient. This collected blood would have to be> sent to a centrifuge for the first stage of the process.

Plasmapheresis

The collected blood is centrifuged to separate the plasma from> the RBCs, this plasma is treated by removing the antibodies igG> and igM i.e., anti-A and anti-B antibodies. In some cases, the> plasma can also be replaced with a AB group plasma since the> AB group does not contain any antibodies naturally. This would> help mitigate hemolytic-transfusion reactions [7]. This plasma> can also be replaced with an alternative solution such as saline or> albumin. According to a paper by Trung C. Nguyen, M.D,> Joseph E. Kiss, M.D, Jordana R. Goldman, M.D and Joseph A.> Carcillo, M.D in the article “the role of plasmapheresis in critical> illness”, this procedure has proven to be successful in ABO> incompatible organ donations.

Immunoadsorbption

The collected plasma is then passed into cellulose beads of a> immune absorbent for the anti-A and anti-B antibodies in the> blood for the complete removal of the specific antibodies from> the blood. This procedure is proven to be successful in doing> the following according to a paper published by W I Bensinger,> C D Buckner, R A Clift titled “whole blood immune adsorption> of anti-A or anti-B antibodies” [8].

Conclusion

This procedure has been proven by many other doctors as an> efficient method for the removal of antibodies from the blood.> This can replace the need of a rare blood donor immediately as> the patient’s body would be able to sustain on the conditioned> plasma and reduce fatalities. The patient however would have to> be under a regular dose of immune suppressants to make sure there are no complications until the recipient receives the> required blood type and will have to be closely monitored. This> procedure can also be adopted while performing surgeries on> patients who have suffered severe trauma instead of using units> of rare blood which could be later transfused to the patient postop.

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