A double buffy coat method for red cell removal from ABO‐incompatible marrow

Hemolytic reactions caused by transfusion of ABO‐incompatible marrow can be ameliorated by either reduction of isohemagglutinins in the recipient or depletion of incompatible red cells from the harvested marrow. This article describes a rapid and reliable method for removal of incompatible marrow red cells on a blood cell processor using a double buffy coat technique. In five allogeneic bone marrow transplants, the maximum value of transfused incompatible red cells was 8.8 ml. There was no evidence of a hemolytic transfusion reaction in any patient. The median cell recovery for nucleated marrow cells and progenitor cells was 77 and 104 percent, respectively. Engraftment occurred at a median of 13 days (range, 11–21 days) after transplantation. The double buffy coat method of red cell depletion is an acceptable method for processing ABO‐incompatible marrow.

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