de França NG, Poli MC, Ramos PG, Borsoi CS, Colella R ABO matched PLT transfusions, the authors concluded that transfusion medicine services should consider measures to increase ABO-identical PLT transfusions and physicians should be aware of potential adverse outcomes when transfusing non-identical ABO PLTs. Also supplying ABO- identical PLTs to all patients has significant resource implications given that there is currently a limited supply of these products and supply may not match the demand for these products.(14) With the abundance of Group O donors, methods to increase the safety of Group O products should be developed. European strategies have defined a safe level of isohemagglutinins for their donors and a cut-off determination to label products when the titer is high and thereby restrict its use.(15) The challenge is for us to re-examine our practices and policies to ensure successful transplantation and transfusion and when necessary use non-identical ABO blood. The greatest challenge is to convince the authorities do establish, at a national level, a safe level of ABO antibodies in group O blood transfusions. References 1. Malomgre W, Neumeister B. Recent and future trends in blood group typing. Anal Bioanal Chem. 2009;393(5):1443-51. 2. Klein HG, Anstee DJ. Mollison`s blood transfusion in clinical medicine. 11a ed. Oxford, UK: Blackwell Publishing; 2005. p 406- 54. Chapter 10: Red cell incompatibility in vivo. 3. Daniels G. Human blood groups. 2nd. Edition. Blackwell Publishing; 2002. 4. Tobian AA, Shirey RS, Montgomery RA, Ness PM, King KE. The critical role of plasmapheresis in ABO-incompatible renal transplantation. Transfusion. 2008;48(11):2453-60. 5. Cooling LL, Downs TA, Butch SH, Davenport RD. Anti-A and anti- B titers in pooled platelets are comparable to apheresis platelets. Transfusion. 2008;48(10):2106-13. 6. Brasil. Agência Nacional de Vigilância Sanitária. Resolução RDC nº 57, de 16 de Dezembro de 2010. Determina o regulamento sanitário xxx para serviços que desenvolvem atividades relacionadas ao ciclo produtivo do sangue humano e componentes e procedimentos transfusionais [Internet]. Brasilia: ANVISA; 2010. [cited 2011 Jan 12]. Available from: http://www.brasilsus.com.br/legislacoes/ rdc/106696-57.html. Portaria do Ministério da Saúde nº 1.353, de 13.06.2011 - Diário Oficial da União 14.06.2011. 7. Mazda T, Yabe R, NaThalang O, Thammavong T, Tadokoro K. Differences in ABO antibody among blood donors: a comparision between past and present Japanese, Laotian and Thai populations. Immunohematology.2007;23(1):38-41. Erratum in: Immunohematology. 2008;24(1):28. 8. Johnson DJ, Leitman S, Klein H, Alter H, Stroka AL, Scheinberg P, et al. Probiotic-associated high- titer anti-B in a group A platelet donor as a cause of severe hemolytic transfusion reactions. Transfusion. 2009;49(9):1845-9. 9. Perez N, Iannicelli JC, Girard-Bosch C, Gonzalez S, Varea A, Disalvo L, et al. Effect of probiotic supplementation on immuno- globulins, isoagglutinins and antibody response in children of low socio-economic status. Eur J Nutr. 2010;49 (3):173-9. 10. Fernandes VC, Borgatto AF, Barberato Filho S, Toledo MI, Lopes LC. Freqüência de hemolisinas anti-A e anti-B em doadores de sangue de Itapeva e Ourinhos. Rev Bras Hematol Hemoter. 2008; 30(6):453-6. 11. Kumlien G, Wilpert J, Säfwenberg J, Tydén G. Comparing the tube and gel techniques for ABO antibody titration, as performed in three European centers. Transplantation. 2007;84(12 Suppl): S17-9. 12. Tanabe K. Interinstitutional variation in the measurement of anti- A/B antibodies: the Japanese ABO-Incompatible Transplantation Committee Survey. Transplantation. 2007;84(12 Suppl):S13-6. 13. Rieben R, Buchs JP, Flückiger E, Nydegger UE. Antibodies to histo-blood group substances A and B: agglutination titers, Ig class, and IgG subclasses in healthy persons of different age categories. Transfusion.1991;31(7):607-15. Comment in: Transfusion. 1991; 31(7):577-80. 14. Shehata N, Tinmouth A, Naglie G, Freedman J, Wilson K. ABO- identical versus nonidentical platelet transfusion: a systematic review. Transfusion. 2009;49(11):2442-53. 15. Josephson CD, Castillejo MI, Grima K, Hillyer CD. ABO- mismatched platelet transfusions: strategies to mitigate patient exposure to naturally occurring hemolytic antibodies. Transfus Apher Sci. 2010;42(1):83-8. 262 Rev Bras Hematol Hemoter. 2011;33(4):259-62