Anti-A agglutinins in pooled plasma as a cause of hemolytic anemia.

By JULIUS BITZKY, FI oSsIF CohEN ANt) \\‘OLF W. Zui I z:R T lIE AD\1IXISTRATI()X of P00l( (I 1)1asn a to i’ecipietits of all A130 blood groups is generally regarded as safe because of the assumed (lilution and neutralization of the anti-A and anti-B isoantibodies in the P00l. The extensive use of pooled plasma (luring World War II failed to bring to light any significant danger of hemolytie reactions.’-7 On the (olltrarv, it was this l)ody of information which led to the pra(ti(e of giving pooled plasma in unrest rated quantities without regard for the 1)loo(l-grou ) of the recipient. Only Ebert and Emerson8 seem to have presented ol)servations indicating a hazard (onnected with the isoantibody content of pooled plasma. Ihese authors noted an increase in the osmotic fragility and a decrease in the survival of the red corpuscles of patients of blood groups other than 0 who had received multiple transfusions of pooled plasma.* Unfortunately, in the experinients of Ebert and Emerson, the saline A and B agglutinin titers of the plasma pools used were miot recorded and the newer methods fom’ the detection of special ‘‘immune’’ anti-A and anti-B were not yet available. Thus neither the quantitative nor tiualitative characteristics of the isoantibodies contained in the plasma pools were investigated. Moreover, with but one exception, the patients studied by these authors had received group 0 whole blood immediately prior to the administration of the pooled plasma. It is perhaps for these reasons that the implications of their study do not seem to have beeti widely appreciated. In the meantime, the occasional hemolytie react ions attending the use of