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The text reviews strategies to reduce platelet-associated HTRs, including platelet volume reduction and screening donor plasma with anti-A/anti-B titration or in vitro hemolysis assays. It evaluates limitations of standardized “critical titers,” explains regulatory interest in the hemolysin test as prophylaxis, and highlights evidence that isohemagglutinin titration and qualitative hemolysin results may not correlate and do not fully prevent RBC sensitization.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/abo-isohemagglutinin-titration-or-hemolysin-test-what-should-we-do-to-reduce-the-risk-of-passive-hemolysis/470115/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/abo-isohemagglutinin-titration-or-hemolysin-test-what-should-we-do-to-reduce-the-risk-of-passive-hemolysis/470115.png","ImageObject",300,407,{"name":92,"@type":93},"acoobca","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-08","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":24},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why are ABO-incompatible platelet transfusions sometimes accepted?","Question",{"text":112,"@type":113},"They are used when ABO-identical platelets are unavailable due to generally insufficient inventories and a higher frequency of group O donors.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How does passive hemolysis occur in this transfusion context?",{"text":117,"@type":113},"Acutely hemolytic transfusion reactions can result from passive transfer of donor antibodies (anti-A and/or anti-B) that have unusually high titers.",{"name":119,"@type":110,"acceptedAnswer":120},"What does the text say about the relationship between isohemagglutinin titration and the hemolysin test?",{"text":121,"@type":113},"Results of isohemagglutinin titration are not related to the results of the qualitative hemolysin test, and the absence of hemolysis does not prevent red blood cell sensitization.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},470115,1790776736,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":24,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":129,"read_time":24,"preview_page_count":4},3985747870733,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","rev bras hematol hemoter. 2 0 1 5;3 7(4):215–216  \nRevista Brasileira de Hematologia e Hemoterapia  \nBrazilian Journal of Hematology and Hemotherapy  \n[www . rbhh . org](www . rbhh . org)  \n| Scientific Comment\u003Cbr>ABO isohemagglutinin titration or hemolysin test: what should we do to reduce the risk of passive hemolysis?􀀂\u003Cbr>Lilian Castilho 􀀂\u003Cbr>Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brazil | |\n| --- | --- |\n| a r t i c l e i n f o\u003Cbr>Article history:\u003Cbr>Received 14 April 2015 Accepted 14 April 2015 Available online 18 May 2015 |  |\n\nPlatelet concentrates from ABO-identical donors are the components of choice for transfusions. Since platelet inventories are generally insufficient and because there is usually a higher frequency of group O donors, perfect matches are not always possible and therefore ABO-incompatible platelet transfusions are an accepted practice when ABO-identical platelets are unavailable.1 However, an acute hemolytic transfusion reaction (HTR) can be a severe complication after this typeof transfusion due to the passive transfusion of antibodies from donors possessing unusually high-titers of anti-A and/or anti-B antibodies.2  \nReducing the risk of HTRs due to plasma-incompatible platelet transfusions has been generating interest and discussions. Strategies to reduce the risk of platelet-associated HTRs include volume reduction of platelets and screening donor plasma for high titers of antibodies by performing antiA and/or anti-B titration or assays for in vitro hemolysis.1  \nMethods currently employed to identify high titers of antiA and/or anti-B antibodies include titration by the saline agglutination test, with and without incubation, gel test,  \nsolid-phase test, flow cytometry, automated technologies anda qualitative hemolysin test. Many countries have adopted universal screening where a critical IgM titer is between 64 and 100 in tube or gel tests, and a critical IgG titer is between 200 and 512.3,4 However, non-standardized methods ofIgM or IgG isohemagglutinin titration and the lack of agreement of a ‘critical titer’ that will predict in vivo hemolysis have made the determination of ABO antibody titers difficult and limited to a few blood banks.5 Additionally, documentation that titer methods prevent HTRs is not clear. Based on this, it remains unclear whether titration is the best or most cost–effective approach. Currently, the use of the hemolysin test for the identification of hemolytic anti-A and anti-B antibodies has emerged as a useful screening test to identify high levels of anti-A and/or anti-B antibodies and has recently been suggested by the Brazilian legislation as prophylaxis for acute HTRs.  \nRegulatory agencies require that blood banks have a policy to prevent HTRs due to plasma-incompatible platelet transfusions but the choice of the best approach to predict HTRs  \nDOI of original article: [http://dx.doi.org/10.1016/j.bjhh.2015.05.001](http://dx.doi.org/10.1016/j.bjhh.2015.05.001) .  \n􀀂 See paper by Landim et al. on pages 217–22.  \n􀀂 Correspondence to: Centro de Hematologia e Hemoterapia, Universidade Estadual de Campinas (Unicamp), Rua Carlos Chagas 480, Barão Geraldo, 13081-970 Campinas, SP, Brazil.  \nE-mail address: [castilho@unicamp.br](castilho@unicamp.br)[ ](castilho@unicamp.br)[http://dx.doi.org/10.1016/j.bjhh.2015.04.002](http://dx.doi.org/10.1016/j.bjhh.2015.04.002)  \n1516-8484/© 2015 Associaão Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier Editora Ltda. All rights reserved.  \nis still a big challenge as little is known about the correlation between isohemagglutinin titration and the hemolysin test, and the impact of each test on the prevention of hemolysis and on platelet inventory management.  \nIn this issue, there is an important study on the correlation between isohemagglutinin titration and the qualitative hemolysin test as prophylactic tests to prevent HTRs.6 The authors evaluated the impact of each prophylaxis on platelet","cbCaiiTHGpeiCNq6","https://ap.wps.com/l/cbCaiiTHGpeiCNq6","pdf",165203,"English","# Strategies to reduce passive hemolysis risk\n## Donor screening methods and “critical titer” limitations\n## Hemolysin test as prophylaxis and inventory impact\n## Conclusions and remaining research needs","[{\"question\":\"Why are ABO-incompatible platelet transfusions sometimes accepted?\",\"answer\":\"They are used when ABO-identical platelets are unavailable due to generally insufficient inventories and a higher frequency of group O donors.\"},{\"question\":\"How does passive hemolysis occur in this transfusion context?\",\"answer\":\"Acutely hemolytic transfusion reactions can result from passive transfer of donor antibodies (anti-A and/or anti-B) that have unusually high titers.\"},{\"question\":\"What does the text say about the relationship between isohemagglutinin titration and the hemolysin test?\",\"answer\":\"Results of isohemagglutinin titration are not related to the results of the qualitative hemolysin test, and the absence of hemolysis does not prevent red blood cell sensitization.\"}]","ABO isohemagglutinin titration or hemolysin test: what should we do to reduce the risk of passive hemolysis? | PDF"]