Principle:

Since group AB plasma is in short supply, use of group A plasma with low anti-B titers may be substituted based on inventory levels.

Policy:

1. If the AB inventory is low, we will test group A donors at the time of collection for anti-B titers.
   1. The numbers to be tested will depend on the level of the shortage and the availability of equipment to perform titration.
2. Use the automated analyzer to perform saline anti-B.
   1. If the saline titer is less than or equal to 1:64, the plasma may be used for recipients of any ABO blood group and will be labelled as group AU—A Universal.
3. Process the unit routinely and perform pathogen-inactivation.
4. Medinfo Hematos IIG will only label for universal use if the titer is below the cutoff.
   1. The ISBT label must explicitly show group AU plasma and the actual anti-B titer.
5. Allocation rules for low-titer group A plasma will be identical to group AB except:
   1. For neonates, preferentially use group AB.
   2. For children < 20 kg, use ABO-compatible plasma (non-group AB) before selecting group AB or if not available, low-titer A in that order.
6. Donors must have a new anti-B titer performed each donor encounter.

References:

1. Technical Manual, Current Edition, Bethesda, MD, USA
2. Standards for Blood Banks and Transfusion Services Current Edition, AABB, Bethesda, MD, USA