ABO-mismatched platelet transfusions: Strategies to mitigate patient exposure to naturally occurring hemolytic antibodies

Clinically significant hemolysis is a rare but potentially severe complication of administering an ABO-mismatched platelet transfusion. Platelet products from Group O donors, particularly single donor platelets (SDP) are most commonly implicated in these reactions. This is due to the presence of unusually high titers of anti-A which can be found in the plasma of some Group O donors and the large plasma volume of SDPs. These products can cause significant hemolysis when infused into a Group A or AB recipient. Random donor platelets from Group O donors have also been implicated.