{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T07:58:49Z","timestamp":1787731129378,"version":"build-2784847793"},"reference-count":4,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T00:00:00Z","timestamp":1712102400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2024,5]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n \n The U.S. Centers for Disease Control and Prevention (CDC) has reported increasing rates of alpha\u2010gal syndrome, an allergic response after meat ingestion (AGS). AGS has been associated with prior exposure to tick bites or other biologics characterized by a life\u2010threatening immunoglobulin E (IgE)\u2013mediated hypersensitivity to galactose\u2010alpha\u20101,3\u2010galactose (alpha\u2010gal) an oligosaccharide structurally similar to the group B antigen on red blood cells (RBC) found in most non\u2010primate mammalian meat and products derived from these mammals. In 2023,\n Transfusion<\/jats:italic>\n reported 3 group O recipients of group B plasma in the Washington, D.C. metropolitan area with no history of meat allergy who had anaphylactic transfusion reactions compatible with AGS.\n <\/jats:p>\n <\/jats:sec>\n \n Aims<\/jats:title>\n We investigated allergic reactions in 2 additional patients who received ABO minor\u2010incompatible blood products at 2 hospitals in the D.C. area during fall 2023.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n For both patients, a medical chart review was performed and IgE levels to alpha\u2010gal were measured.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The first patient, a 64\u2010year\u2010old, O\u2010positive patient status post heart transplant with no known allergies, was admitted with acute COVID\u201019 induced antibody\u2010mediated transplant rejection and placed on extracorporeal membrane oxygenation (ECMO). While undergoing plasma exchange (PLEX) (50% albumin\/50% fresh frozen plasma (FFP)), the patient tolerated 2 units of group O FFP and 1 unit of group A FFP before becoming hemodynamically unstable during transfusion of 1 unit of B\u2010positive FFP. PLEX was stopped. The patient later died of sepsis from underlying causes. The second patient, a 57\u2010year\u2010old O\u2010positive man with a history of melanoma and neuro fibromatosis type 1, was undergoing an abdominal resection including transfusion of 3 units of O\u2010positive RBC when he suffered hypotension and ventricular tachycardia requiring intraoperative code after receiving 2 units of group B FFP. Hiveswere noted after resuscitation. The patient had a history of tick bites but no known allergies. He is alive 5 months after the possible allergic event. Both patients had full transfusion reaction evaluations and immunology testing results above the positive cutoff for anti\u2010alpha\u2010gal IgE.<\/jats:p>\n <\/jats:sec>\n \n Discussion and conclusion<\/jats:title>\n Two patients with O\u2010positive blood and no known allergies experience danaphyl axis after transfusion with group B FFP. The symptoms cannot definitively be imputed to an allergic transfusion reaction, but the presence of IgE against alpha\u2010gal supports an association. Medicating patients with antihistamines and IV steroids pre\u2010transfusion may prevent allergic reactions. Restricting group B plasma\u2010containing products (plasma, platelets, cryoprecipitate) for patients who experience AGS\u2010like symptoms may be considered.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/trf.17811","type":"journal-article","created":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T03:14:06Z","timestamp":1712114046000},"page":"949-951","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Consideration for\n alpha\u2010gal<\/scp>\n syndrome in two critically ill persons with group O blood who received group B plasma"],"prefix":"10.1111","volume":"64","author":[{"given":"Maureen J.","family":"Miller","sequence":"first","affiliation":[{"name":"Department of Transfusion Medicine National Institutes of Health Clinical Center Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine National Institutes of Health Clinical Center Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian G.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine MedStar Washington Hospital Center Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1631-7198","authenticated-orcid":false,"given":"Willy A.","family":"Flegel","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine National Institutes of Health Clinical Center Bethesda Maryland USA"},{"name":"Department of Pathology Georgetown University Medical Center Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamille","family":"West\u2010Mitchell","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine National Institutes of Health Clinical Center Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Conry\u2010Cantilena","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine National Institutes of Health Clinical Center Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"De Giorgi","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine National Institutes of Health Clinical Center Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4,3]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7230a2"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7230a1"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.17521"},{"key":"e_1_2_5_5_1","unstructured":"TobianAAR.Immunologic Transfusion Reactions.2023.https:\/\/www.uptodate.com\/contents\/immunologic\u2010transfusion\u2010reactions?sectionName=ALLERGIC%20REACTIONS&topicRef=95132&anchor=H1384219212&source=see_link#H1384219212"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.17811","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,11]],"date-time":"2024-05-11T13:12:16Z","timestamp":1715433136000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/trf.17811"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,3]]},"references-count":4,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1111\/trf.17811"],"URL":"https:\/\/doi.org\/10.1111\/trf.17811","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"value":"0041-1132","type":"print"},{"value":"1537-2995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,3]]},"assertion":[{"value":"2023-12-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}