Ahmed Alotaibi: Can We “Remove” the ABO Problem from Group O Platelets?
Ahmed Alotaibi, Senior Specialist (Blood bank and blood transfusion) at Afif General Hospital – Riyadh Third Health Cluster (Ministry of Health), shared a post on LinkedIn:
“Can we ‘remove’ the ABO problem from group O platelets?
ABO-identical platelets are preferred whenever possible.
But with a shelf life of only 5-7 days, ABO-nonidentical transfusion is sometimes unavoidable.
The concern?
Group O platelet plasma may contain high-titre anti-A and anti-B, which can cause haemolysis when transfused to non-O recipients.
A new 2026 Transfusion study tested a different approach:
Instead of simply identifying and avoiding high-titre units, researchers tried to remove the antibodies themselves.
Six group O apheresis platelet units were treated using an ABO antibody immunoadsorption column.
After a single pass:
- IgM anti-A/B: 128 to equal to or less than 4.
- IgG anti-A/B: 512 to equal to or less than 8.
Platelet recovery was also largely preserved, with an average platelet loss of about 5%.
Interestingly, using the same column for a second unit was less effective, suggesting that its antibody-binding capacity may become saturated.
Could this create a more ABO-flexible platelet product?
Possibly, but not yet.
This was a small pilot study involving only six units, with no clinical transfusions.
Some changes in platelet activation and metabolism were also observed during storage.
So larger studies and clinical validation are still needed.
But the concept is fascinating:
High-titre group O platelets – antibody removal – potentially safer ABO-mismatched transfusion
Instead of only managing the risk of anti-A and anti-B, could future blood centres simply remove them?”
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