Citations 2
Epidemiologic Study of Transfusion-Related Alpha-Gal Syndrome
Kaufman, Richard M., Hoen, Anne G., Khan, Jenna, Knudson, C. Michael, Romero, Andres E. Mindiola, Mo, Allison , Takanashi, Minoko , Collaborative, UPTICK Study Group; for the Biomedical Excellence for Safer Transfusion (BEST), Cardigan, Rebecca, Stanworth, Simon J., Commins, Scott P. , Scherer, Emily A., Davenport, Robertson D., Afraz, Sajjad, Andrews, Jennifer , Casey, John, Sullivan, Jensyn Cone , Cousins, Clara C. , Giorgi, Valeria De , Delaney, Meghan, DelBaugh, Regina M. , Gilstad, Colleen W. , Gofton, Alexander , Hill, Kate, Hogan, Keenan , Humbrecht, Catherine , Ikeda, Kazuhiko, Javanbakht, Ayda, Juskewitch, Justin E, Wojtowicz, Monique M. Menzies, Miller, Maureen J., Mills, Georgia, Nelson, Anna C. , Pauly, Marie C., Poisson, Jessica , Raval, Jay S., Samy, Nikitha, Sato, Tomohiko, Takeda, Yoshinori , Thibodeaux, Suzanne R. , Nunen, Sheryl van, Virk, Mrigender S., West-Mitchell, Kamille, Yamanouchi, Jun, Yoshihara, Satoshi, Zheng, X. Long, Ziman, Alyssa, Cone Sullivan, Jensyn , Kaufman, Richard Max , Hoen, Anne Gatewood , Knudson, Charles Michael , Metcalf, Ryan A. , Schäfer, Richard , Dunbar, Nancy M. , Cardigan, Rebecca A. , Stanworth, Simon J., Scherer, Emily A. , Cervinski, Mark A , Arai, Yasuyuki , Brugnara, Carlo , Allen, Elizabeth S. , Aurich, Konstanze , Casey, John , Cohn, Claudia S. , Crowe, Elizabeth P , Delaney, Meghan , Hendrickson, Jeanne E. , Hill, Kate, Ikeda, Kazuhiko , Jacquot, Cyril , Javanbakht, Ayda , Juskewitch, Justin E. , Lu, Wen , Wojtowicz, Monique Menzies , Miller, Maureen J. , Nelson, Anna , Pagano, Monica B. , Pauly, Marie-Christin , Saifee, Nabiha H , Sato, Tomohiko, Takeda, Yoshinori, Tiberghien, Pierre , Nunen, Sheryl van, Virk, Mrigender , Wood, Erica M , Yoshihara, Satoshi , Zheng, X. Long, Ziman, Alyssa
JAMA Internal Medicine | August 24, 2026 | Volume: No volume available | Issue: No issue available | Pages: No page available
10.1001/jamainternmed.2026.3983
Importance Recent case reports suggest that B antigen–containing blood products may be associated with anaphylactic transfusion reactions in recipients with preformed immunoglobulin E to galactose- α -1,3-galactose (alpha-gal). Objective To test the association of local alpha-gal syndrome (AGS) prevalence and allergic transfusion reaction (ATR) in patients with blood type O. Design, Setting, and Participants In this international, multicenter, retrospective cohort study at academic medical centers, sites were assigned to AGS high- or low-prevalence clusters based on the known geographic distribution of AGS. Data were collected on platelet or plasma transfusions and ATRs during 2020 to 2024. Consecutive patients receiving platelet or plasma transfusions were included. Exposures Patients with blood type O who received B or AB units and patients with blood type O who received O units (reference group) in AGS high- and low-prevalence clusters were compared. Main Outcomes and Measures Before data collection, the hypothesis was that if transfusion-related alpha-gal syndrome (TRAGS) is a true clinical entity, excess ATRs to group B or AB units would be detected in AGS high-prevalence regions exclusively. The main measure was the overall risk ratio (RR) for ATRs to B or AB plasma or platelets in AGS high- vs low-prevalence clusters. Results In total, 558 823 platelet and plasma transfusions at 40 sites in 5 countries were analyzed, of which ATRs occurred in 1744 transfusions (0.3%). In the US AGS high-prevalence cluster (9 sites), significantly more ATRs of any severity occurred among patients with blood type O who received B or AB units vs patients with blood type O who received O units (overall RR, 3.93; 95% CI, 2.96-5.21; P < .001). In contrast, in the primary analysis of the AGS low-prevalence cluster (15 sites), excess ATRs to B or AB units were not detected. In subgroup analyses among patients with blood type O receiving B units, the RR for moderate to severe ATRs was 9.14 (95% CI, 5.39-15.52; P < .001) in the AGS high-prevalence cluster vs 2.15 (95% CI, 1.34-3.47; P = .002) in the AGS low-prevalence cluster. Outside the US, a signal consistent with TRAGS was not detected. Conclusions and Relevance This cohort study provides provocative epidemiologic evidence that TRAGS may be a unique manifestation of AGS and a previously unrecognized risk associated with transfusion. In AGS high-prevalence regions, blood collectors and hospital transfusion services should consider approaches to preventing severe ATRs from B or AB plasma or platelet units.
Variation in Chronic Automated Red Cell Exchange Practices for Sickle Cell Disease: Insights Into Isovolemic Hemodilution Use
Jones, Jennifer M. , Aldarweesh, Fatima , Aqui, Nicole, Bobr, Aleh , Brunker, Patricia A. R. , Covington, Mischa L. , Guarente, Juliana , Hagar, Robert, Karafin, Matthew, Lamba, Divjot Singh , Lee, Grace M. , Mack, Ethan A. , Muthur, Gagan, Nazli, Saadiya, Olaniyan, H S, Raval, Jay S., Setya, Divya , Tanhehco, Yvette C. , Thant, Mamie, Wu, Yanyun , Wong, Edward C.C. , Zheng, Yan , Brunker, Patricia A R , Lee, Grace , Lu, Wen , Mack, Ethan A , Onyenekwu, Chinelo P , Setya, Divya , Tanhehco, Yvette C , Vivero, Angelica , Yurtsever, Nalan , Zheng, Yan , Shi, Patricia A , Webb, Jennifer , Aldarweesh, Fatima , Aqui, Nicole A., Hagar, Robert Ward, Lu, Wen , Nazli, Saadiya , Yurtsever, Nalan , Shi, Patricia A.
Journal of Clinical Apheresis | June 19, 2026 | Volume: 41 | Issue: 3 | Pages: No page available
ABSTRACT Prior surveys of chronic automated red blood cell exchange (RCE) for patients with sickle cell disease (SCD) have identified considerable procedural variability, especially with the use of isovolemic hemodilution red blood cell exchange (IHD‐RCE). We conducted a survey of chronic RCE practices among American Society for Apheresis (ASFA) members to identify opportunities for practice harmonization and future studies. The ASFA SCD Research Subcommittee developed a 72‐item survey of chronic RCE practices, with a focus on IHD‐RCE. The survey was validated internally and distributed by email to all ASFA members from September 2024 to February 2025. One survey response from each institution was retained for data analysis. Descriptive statistics were performed. Sixty‐two survey responses, including three from international institutions, were retained for analysis. Sixty‐one percent of respondents (38/62) reported using at least one fixed RCE target, with end hematocrit being the most common fixed parameter (40%, 25/62), followed by fraction of cells remaining (31%, 19/62) and hemoglobin S% (27%, 17/62). Most respondents (60%, 37/61) performed IHD‐RCE at their institution, though other details such as the minimum hematocrit, exclusion criteria, and response to adverse effects were variable. Consistent pre‐ and post‐RCE laboratory monitoring practices were reported. Consistent with earlier surveys, procedural variability in chronic RCE practices for patients with SCD is observed. This highlights opportunities to compare outcomes where practice variability exists. Consensus guidelines based on institutional practices with optimal outcomes should be developed.