Quantitation of ABO-antibodies in O RhD positive blood donors

Sammanfattning

Following the deterioration of the European security situation and Sweden’s accession to North Atlantic Treaty Organization (NATO) in 2024, the need for blood preparedness and access to whole blood transfusions has increased. Whole blood transfusion has shown significant benefits in trauma care, particularly in prehospital settings, where rapid treatment of massive hemorrhage is crucial for survival. However, transfusion of group O whole blood carries a risk of hemolytic transfusion reactions due to naturally occurring anti-A and anti-B antibodies. Therefore, identification of donors with low ABO antibody titers is essential for safe whole blood donation. The aim of this study was to quantify ABO antibodies among blood donors in Region Dalarna, Region Gävleborg, and Region Västmanland in order to identify suitable whole blood donors and establish local methods for antibody titration. EDTA plasma from 263 male O RhD-positive, Kell-negative blood donors was analyzed using direct agglutination in gel card technology. Samples with antibody titers below 1:250 were classified as low titer and approved for whole blood donation. Of the 263 analyzed samples, six donors (2%) demonstrated high antibody titers, while 257 donors (98%) met the criteria for whole blood donation. No statistically significant differences in antibody titers were observed between the regions. Nor could this study observe any connection between age, number of blood donations and antibody titer. The study demonstrates that the majority of Swedish blood donors are suitable for whole blood donation and provides a foundation for expanding regional whole blood preparedness and prehospital trauma care in Sweden.