New Association Bulletin Addresses Transfusion-Related Alpha-Gal Syndrome

AABB published Association Bulletin #26-04 today, providing recommendations to help hospital transfusion services and blood suppliers recognize and manage transfusion-related alpha-gal syndrome (TRAGS), a potentially serious allergic transfusion reaction.

TRAGS may occur when a patient with alpha-gal syndrome receives a blood component containing B antigen. Because B antigen is present on platelets and in the plasma of some donors, group O patients may be at particular risk when they receive group B or AB platelets or plasma.

The association between alpha-gal sensitization and allergic transfusion reactions is still being investigated. As of July 5, nine presumed cases of TRAGS had been reported in the scientific literature, including one fatal case. Emerging evidence also suggests that the risk of severe allergic reactions following transfusion of group B or AB components may be greater among patients with group O blood who received a transfusion in an area where alpha-gal sensitization is more prevalent.

Given the limited evidence, the new Association Bulletin emphasizes vigilance and a risk-based approach rather than broad changes to transfusion practice. It provides recommendations for identifying suspected cases, managing patients with TRAGS and considering regional strategies to reduce risk.

The bulletin also addresses how transfusion services can assess the prevalence of alpha-gal syndrome in their communities and weigh potential risk-reduction measures against their impact on blood availability. AABB notes that recommendations may evolve as additional data clarify the epidemiology and clinical significance of TRAGS.