From the Research
For recipients of ABO-incompatible (ABOI) transplants, type O blood products should be used for transfusions to minimize the risk of hemolytic reactions. This recommendation is based on the fact that type O red blood cells lack A and B antigens, making them compatible with all blood types and preventing potential hemolytic reactions in these sensitized patients 1. After an ABOI transplant, the recipient's immune system has been specifically conditioned to accept the donor's incompatible blood type organ through desensitization protocols that remove preformed antibodies. However, this accommodation is specific to the transplanted organ and does not extend to transfused blood products. If a recipient were to receive blood products matching the donor's blood type rather than their own, it could trigger a severe hemolytic transfusion reaction as the recipient's remaining antibodies would attack the transfused cells. This precaution typically remains in place indefinitely after transplantation, as the risk of transfusion reaction persists even when the transplanted organ is functioning well 2.
Some key points to consider when managing ABOI transplant recipients include:
- The use of desensitization protocols to remove preformed antibodies and prevent rejection of the transplanted organ 3
- The importance of monitoring anti-A and anti-B antibody titers to ensure that the recipient's immune system is not reacting to the transplanted organ 4
- The need for ongoing immunosuppression to prevent rejection of the transplanted organ 5
- The potential risks and complications associated with ABOI transplantation, including bleeding and infectious complications 1
Overall, the use of type O blood products for transfusions in ABOI transplant recipients is a crucial aspect of their management, as it helps to minimize the risk of hemolytic reactions and ensure the long-term success of the transplanted organ.