Receipt of at least 4 units of low titer group O whole blood with titer <100 does not lead to hemolysis in adult trauma patients

Abstract Background The serological safety of transfusing low titer group O whole blood (LTOWB) with an anti‐A and anti‐B titer of <100 was evaluated in group O and non‐group O trauma recipients. Methods Civilian adult trauma patients who received ≥4 units of leukoreduced LTOWB during their initial resuscitation and who survived for >24 h after admission at two level 1 trauma centers were included in this retrospective study. Lactate dehydrogenase (LDH), total bilirubin, haptoglobin, potassium, creatinine were evaluated on the day of LTOWB transfusion (day 0) and on the next 3 days. Results There were 77 injured recipients evaluated: 39 non‐group O and 38 group O. The median (IQR) number of transfused LTOWB units was 4 (4–6) and 4 (4–5), respectively, and the maximum number of units was 8 and 11, respectively. The non‐group O patients received a median (IQR) volume of 1710 ml (1368–2070) of ABO‐incompatible plasma. Comparing non‐group O to group O recipients, there were no significant differences in the median haptoglobin, LDH, or creatinine concentrations at any time point. The median concentration of total bilirubin was significantly higher amongst the non‐group O recipients on days 1 and 2, while on day 0 the median potassium concentration was significantly higher amongst the group O recipients. All median elevated values were within the laboratory's normal range. Amongst the non‐group O recipients there were no reported transfusion reactions. Conclusion Receiving at least four LTOWB units (anti‐A&B titer <100) was not associated with biochemical/clinical evidence of hemolysis in adult trauma patients.