Severe allergic transfusion reactions to group B/AB plasma or platelets in group O recipients are linked to α-Gal sensitization
Abstract
Allergic transfusion reactions (ATR) are potentially lethal adverse events that occur in ∼0.3% to 6% of plasma or platelet transfusions. The main mechanism described is an immunoglobulin E (IgE)–mediated response to donor proteins, such as IgA and haptoglobin in deficient patients. Recently, in a nationwide retrospective observational study, we reported that group O recipients of group B or AB platelet concentrates or plasma were at significantly higher risk of severe ATR than recipients with other ABO combinations. Given the antigenic proximity between group B determinant and the galactose-α-1,3-galactose (α-Gal) epitope, we hypothesize a role for α-Gal IgE–mediated sensitization in these ATR. In this report, we investigated the presence of anti–α-Gal IgE in a cohort of 59 patients with severe ATR. We found that group O recipients of group B or AB blood components (plasma or platelet concentrates) were substantially more likely to exhibit high titers of group B cross-reactive anti–α-Gal IgE than other patients, supporting our hypothesis that α-Gal sensitization underlies these severe ATR. These findings suggest that α-Gal sensitization is an additional mechanism responsible for ATR in major ABO-incompatible transfusion and should be systematically explored in group O patients having received group B/AB plasma or platelets.
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BibTeX
@article{chaisemartin2026severe,
title = {{Severe allergic transfusion reactions to group B/AB plasma or platelets in group O recipients are linked to α-Gal sensitization}},
author = {Luc de Chaisemartin and Virginie de la Taille and Pascale Nicaise-Roland and Lucile Malard and Cléo Beuscart and Aurélie Gouel-Chéron and Syria Laperche and Pierre Tiberghien},
journal = {Blood},
year = {2026},
month = jun,
doi = {10.1182/blood.2025032045},
url = {https://u-paris.hal.science/hal-05735556v1},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Severe allergic transfusion reactions to group B/AB plasma or platelets in group O recipients are linked to α-Gal sensitization
AU - Luc de Chaisemartin
AU - Virginie de la Taille
AU - Pascale Nicaise-Roland
AU - Lucile Malard
AU - Cléo Beuscart
AU - Aurélie Gouel-Chéron
AU - Syria Laperche
AU - Pierre Tiberghien
PY - 2026
DA - 2026/06/18
JO - Blood
DO - 10.1182/blood.2025032045
UR - https://u-paris.hal.science/hal-05735556v1
AB - Allergic transfusion reactions (ATR) are potentially lethal adverse events that occur in ∼0.3% to 6% of plasma or platelet transfusions. The main mechanism described is an immunoglobulin E (IgE)–mediated response to donor proteins, such as IgA and haptoglobin in deficient patients. Recently, in a nationwide retrospective observational study, we reported that group O recipients of group B or AB platelet concentrates or plasma were at significantly higher risk of severe ATR than recipients with other ABO combinations. Given the antigenic proximity between group B determinant and the galactose-α-1,3-galactose (α-Gal) epitope, we hypothesize a role for α-Gal IgE–mediated sensitization in these ATR. In this report, we investigated the presence of anti–α-Gal IgE in a cohort of 59 patients with severe ATR. We found that group O recipients of group B or AB blood components (plasma or platelet concentrates) were substantially more likely to exhibit high titers of group B cross-reactive anti–α-Gal IgE than other patients, supporting our hypothesis that α-Gal sensitization underlies these severe ATR. These findings suggest that α-Gal sensitization is an additional mechanism responsible for ATR in major ABO-incompatible transfusion and should be systematically explored in group O patients having received group B/AB plasma or platelets.
SN - 0006-4971
SN - 1528-0020
ER -