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ABO Incompatible Transplants: Getting the Right Stuff

ABO Incompatible Transplants: Getting the Right Stuff. Kim and Elma BMT Tandem . Objectives. What was reviewed at the ABO incompatibility session in Hawaii What our patients are asking What is being done at the University and Cell Therapy Facility. ABO Compatability Chart.

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ABO Incompatible Transplants: Getting the Right Stuff

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  1. ABO Incompatible Transplants: Getting the Right Stuff Kim and Elma BMT Tandem

  2. Objectives • What was reviewed at the ABO incompatibility session in Hawaii • What our patients are asking • What is being done at the University and Cell Therapy Facility

  3. ABO Compatability Chart

  4. Rhesus Factor (RH) Factor • A person having the factor is Rh positive, and a person lacking the factor is Rh negative.

  5. Since I am A+, why are you giving me 0- blood? • Yes, 0- is the universal donor. • Type 0 blood does not contain any antigens that your blood types can attack. • You are Rh positive and can receive negative products.

  6. Blood Bank Facts • April.Besse@ARUPLab.com • 5-2134 • BMT guru for ABO and platelet questions • Roadmaps on patients

  7. Road Maps • Confirmatory HLA typing • Hematopoietic stem cell auto or Platelet refractory patient OR platelet donor • Histocompatibility Report from H & I lab (Histocompatability and Immunogenetics Laboratory) found on the A-Z index • Antigens that patient has made antibodies against

  8. Blood Bank Facts • A patient can receive 2 incompatible PLT donors in a week • Platelets and FFP are collected from one donor using apheresis • Two historical clot tubes or one current clot tube on file for Platelet transfusions • CMV negative equivalent product requires a doctor order except with Dr. Tricot’s patients.

  9. Why are you giving me continuous platelets? • “It is in hopes that if we have a constant stream of platelets that a few will slip by the active HLA antibodies. In other non HLA related issues…not be deactivated/destroyed by the patient’s high fever or infection.”

  10. Why am I not getting bumps from my platelets? • Occasionally, patients make antibodies that attack donor platelets • A test called a HLA antibody screen is done that checks which antigens the body has made antibodies against • Special donors are called in that match you

  11. Platelet compatability If I’m 0+, can I recieve AB+ PLTs?

  12. Platelet compatability If I’m AB+, can I get 0+ PLTs?

  13. My HSCT donor is A+ and I’m B+ what type of blood will you give me? • You will receive 0- or 0+ until your chimerisms show that you are 100% donor. • Chimerisms are obtained at Day 100 and one year • Blood bank will continue to do T&S prior to each transfusion

  14. Patient DB • HLA type A (1,2) B (51.57) Avoid: B (62,50, 72, 56, 27, 49, 61, 76, 7,60, 81, 55, 71, 67, 75, 45, 41, 42, 48, 82, 39, 54, 35,13, 8, 18, 73, 78, 65, 64, 46, 52, 63) • Can use A (3, 28, 11) B ( 15, 53, 17, 5, 5, 58, 70)

  15. Major ABO incompatbility Premeds Benadryl 25-50 mg PO/IV Tylenol 650 mg Hydrocortisone 100 mg IV Mannitol 12.5 gm IV BMT Clinical Standards: MARROW-DERIVED AND PERIPHERAL BLOOD PROGENITOR CELL INFUSIONS

  16. Minor ABO incompatbility Premeds Benadryl 25-50 mg PO/IV Tylenol 650 mg Hydrocortisone 100 mg IV BMT Clinical Standards: MARROW-DERIVED AND PERIPHERAL BLOOD PROGENITOR CELL INFUSIONS

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