Universal donors (group O) are used very commonly for patients belonging to other blood groups. There is a theoretic risk of incompatibility from the use of universal donors whose serum iso-agglutinins are of high titer. Gesse1 collected forty-six instances of incompatibility resulting in twenty deaths following the use of blood from a universal donor. On the basis of agglutinin titrations he found that more than 30 per cent of universal donors have an agglutinin titer over 1:32, a titer which he considers dangerous. It is obvious that practical experience does not confirm these fears. Vast numbers of transfusions from universal donors are given with complete safety. The rare occurrence of an incompatibility reaction is more apt to be due to inaccurate blood grouping from the use of weak typing serums and weak agglutinogen. Erroneous blood grouping is a more frequent cause of incompatibility.2
Why can serum containing iso-agglutinins
LEVINSON SO, CRONHEIM A. SUPPRESSION OF ISO-AGGLUTININS: AND THE SIGNIFICANCE OF THIS PHENOMENON IN SERUM TRANSFUSIONS. JAMA. 1940;114(21):2097–2098. doi:10.1001/jama.1940.02810210029010
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