ABO Titre - Bone Marrow or Renal Transplant of ABO incompatible Patients

Patients receiving ABO incompatible renal transplants are subjected to immunosuppressive regimes and plasma immunoadsorption to remove naturally occurring ABO antibodies. Titres are carried out to quantify the recipients antibody level against the incompatible antigen of the renal donor as a measure of potential risk of donor transplant rejection. Samples will usually be titred pre transplant and will be required to be titred again urgently post transplantation. Successful transplants will require follow-up titres for approximately 6 months post transplantation. The laboratory should be made aware of these requests beforehand to ensure testing can be performed promptly.
Clinical details: 
For further information please refer to the GSTT Clinical Guidance Policy.
Reference range: 


Synonyms or keywords: 
ABO incompatible, renal transplant, Bone Marrow Transplant
Sample type and Volume required: 
Griener Vacutte K3EDTA 6 mls whole blood for adult tube (Pink top)
Griener Vacutte K2EDTA 4 mls whole blood for adult tube (Purple top)

In regards to sample testing, whole blood samples stored at room temperature are valid for 48 hours.
A Group and save must also be requested for ABO Titre and is performed using the same sample.
Call in advance: 
Special sample instructions: 

Samples for Transfusion testing must include the following minimum details:

All details must be legibly handwritten on the blood tube.


Surname (in full)

Forename (in full)

GSTT Hospital Number*

Date of Birth

Date and time of sample


Signature of the person taking the sample

*Most samples from GP surgeries may be accepted without a hospital number. However samples for transfusion testing on antenatal patients must always have a GSTT hospital number.

Factors affecting the results:

Samples must be processed within 48 hours of collection, samples received after this time may give erroneous results due to antibody deterioration and therefore will not be reported. Patient and donor ABO groups are required to determine the cells used for the titration, incorrect donor group information will lead to incorrect ABO cells being selected for the titration. The presence of other atypical antibodies in the patient plasma may cause falsely elevated results in the ABO titre therefore, patients with a positive antibody screen will have to be referred to the red cell immunohaematology laboratory at NHSBT. 

Storage and transport: 
Sample Retention: Samples are stored for 7 days.
Blood Transfusion Laboratory at Guy's and St Thomas' Hospital
020 7188 4774
Blood Transfusion Laboratory
St Thomas' Hospital
North Wing, 5th Floor
St Thomas' Hospital
Westminster Bridge Road
London SE1 7EH

Blood Transfusion Laboratory
Guy's Hospital
Southwark Wing, 4th Floor
Great Maze Pond
London SE1 9RT
For clinical advice or interpretation of results, please contact the laboratory in the first instance.

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Last updated: 25/08/2022