Advancing Transfusion Medicine in Sea Turtles: An Optimized Protocol for Cross-Matching Whole Blood
Abstract
Whole blood transfusions are occasionally indicated in sea turtle rehabilitation, but standardized protocols for transfusion medicine in reptiles are unavailable in the literature.1 The objective of this study was to optimize a cross-matching protocol that can reliably be utilized for sea turtle blood transfusions. Samples from fifteen turtles [n=14 green turtles, Chelonia mydas (Cm); n=1 loggerhead sea turtle, Caretta caretta (Cc)] were tested using a temperature-appropriate, time-sensitive protocol in 26 reactions using two procedures and evaluation between 2 to 60 minutes. Although hemolysis was absent in all samples, the major cross-match identified 7/22 incompatible Cm-Cm reactions by microscopic agglutination. Minor cross-matches resulted in 6/22 incompatible Cm-Cm reactions. About half of all Cm-Cm reactions (12/22) were compatible by major and minor cross-match. All Cc-Cm reactions were incompatible. A higher than expected proportion of incompatible Cm cross-matching reactions suggests pre-existing antibodies to non-self red blood cell (RBC) antigens in this species or other factors promoting RBC aggregation. Preliminary data across Cm and Cc suggests cross-species incompatibility. These results indicate that unlike some mammals and the assumption with reptiles in which it is generally considered safe to give the first blood transfusion without consequences of a transfusion reaction,2 these animals may react to donor RBC even at first transfusion. Concurrent major and minor cross-matching using the proposed protocol in sea turtles should be considered a necessary and effective way to test for patient and donor incompatibilities, and this technique furthers the ability to care for the critical patient.
Acknowledgements
The authors wish to thank Richie Moretti, Caitlin Greene, and the entire staff of the Turtle Hospital for their excellent care of turtles and dedication to research.
* Presenting author
+ Student presenter
Literature Cited
1. Mader DR, Rudloff E. 2006. Emergency and critical care. In: Mader DR, ed. Reptile Medicine and Surgery. 2nd ed. St. Louis, MO: Elsevier; 533–548.
2. Tocci LJ, Ewing PJ. 2009. Increasing patient safety in veterinary transfusion medicine: an overview of pretransfusion testing. J Vet Emerg Crit Care. 1:66–73.