Christina L. Dean

Transfusion-transmitted malaria masquerading as sickle cell crisis with multisystem organ failure.

Fever accompanying vaso‐occlusive crisis is a common presentation in patients with sickle cell disease (SCD) and carries a broad differential diagnosis. Here, we report a case of transfusion‐transmitted malaria in a patient with SCD presenting with acute vaso‐occlusive crisis and rapidly decompensating to multisystem organ failure (MSOF).

Stability of anti-A blood group titers among blood group B renal transplant candidates: STABILITY OF ANTI-A BLOOD GROUP TITERS

As deceased donor kidney allocation is based in part on blood type compatibility, group B candidates are disadvantaged due to their disproportionate representation on the wait list compared to the group B donor pool. To mitigate this discrepancy, group B candidates can receive group A2 or A2B donor kidneys if their anti‐A titers are below a predetermined cutoff. Currently, eligibility is reverified quarterly to UNet based on individual center protocols, which can vary due to a lack of set guidelines for monitoring ABO titers in these patients. Our goal was to assess the stability of anti‐A titers in blood group B renal transplant candidates over time to provide data that could aid in the development of standardized ABO titer protocols.

Current state of transfusion practices for ABO-incompatible pediatric heart transplant patients in the United States and Canada: PEDIATRIC ABOiHT TRANSFUSION SUPPORT

ABO compatibility restriction on solid organ transplantation limits organ availability. In an effort to increase organ availability, pediatric ABO‐incompatible heart transplants (ABOiHT) are now performed with similar outcomes to ABO‐compatible transplants. Transfusion support can be challenging and currently there are no standard guidelines for blood product support, ABO isohemagglutinin (IH) titer cutoffs for transplant eligibility, or therapeutic intervention for these patients. The study aim was to survey current blood bank and antibody reduction practices for pediatric ABOiHT in the United States and Canada.

F)Utility of the physical crossmatch for living donor evaluations in the age of the virtual crossmatch

Flow cytometric crossmatches (FCXM) are routinely performed to support living-donor renal transplantation. While long a laboratory mainstay, a physical crossmatch is costly, time consuming, and frequently poses interpretative conundrums with both false-positive and false- negative results. Given the increased utilization of the virtual crossmatch (vXM) in the deceased donor setting, our aim was to assess its utility in living donor evaluations. We reviewed 100 living donor FCXMs and retrospectively performed a vXM for each pair. Seventy-five (75) cases were concordant, (i.e., FCXM-/vXM- or FCXM+/vXM+) while 25 cases were discordant; Five were vXM+/FCXM- and 20 were FCXM+/vXM-. Since donor-specific antibodies (DSA) were not detected in the 20 FCXM+/vXM- cases, these were interpreted as false-positive, i.e., due to non-HLA antibodies. Importantly, none of these patients, when transplanted across a positive FCXM, experienced early antibody mediated rejection or subsequently developed HLA DSA. These data reveal that, for the vast majority of living donor evaluations, a vXM is an acceptable vetting procedure.

Contribution of alternative complement pathway to delayed hemolytic transfusion reaction in sickle cell disease

Transfusion of red blood cells (RBC) remains a primary treatment modality in patients with sickle cell disease (SCD). Repeated exposure to alloantigens on transfused RBCs can lead to alloantibody formation that can increase the risk of delayed hemolytic transfusion reaction (DHTR).[1][1] The