Large international cohort study identifies a strong association between allergic transfusion reactions (ATRs) and transfusion of B or AB plasma/platelets in blood type O recipients in AGS high-prevalence regions.
Risk ratios for moderate to severe ATRs in patients with blood type O receiving B units reach over 9-fold in AGS-endemic areas, underscoring a unique transfusion-related manifestation of AGS (TRAGS).
Geographic heterogeneity highlights the importance of regional AGS prevalence in risk assessment and transfusion practice policies.
Existing ABO-mismatched transfusion practices, particularly in platelet and plasma components, provide potential exposure pathways to alpha-gal antigen, emphasizing the need for tailored transfusion strategies in AGS-prevalent populations.
