BACKGROUND AND OBJECTIVES: The consequences of ABO-compatible non-identical plasma for patient outcome have not been studied in randomized clinical trials or large cohort studies and use varies widely in the absence of evidence-based policies. We investigated if transfusion with compatible instead of identical plasma confers any short-term survival disadvantage on the recipients. MATERIALS AND METHODS: The cohort of all 86 082 Swedish patients who received their first plasma transfusion between 1990 and 2002 was followed for 14 days and the risk of death in patients exposed to compatible non-identical plasma compared to recipients of only identical plasma. RESULTS: After adjustment for potential confounding factors, there was an increased mortality associated with exposure to ABO-compatible non-identical plasma, with the excess risk mostly confined to those receiving 5 or more units (relative risk, 1.15; 95% confidence interval, 1.02-1.29). Stratification by blood group indicated higher risks in group O recipients, especially when the compatible plasma was from a group AB donor. CONCLUSIONS: This study suggests that ABO-compatible non-identical plasma is less safe than identical plasma. Subanalyses by blood group suggest a role for circulating immune complexes. Our findings may have policy implications for improving transfusion safety.
BACKGROUND AND OBJECTIVES: The consequences of ABO-compatible non-identical plasma for patient outcome have not been studied in randomized clinical trials or large cohort studies and use varies widely in the absence of evidence-based policies. We investigated if transfusion with compatible instead of identical plasma confers any short-term survival disadvantage on the recipients. MATERIALS AND METHODS: The cohort of all 86 082 Swedish patients who received their first plasma transfusion between 1990 and 2002 was followed for 14 days and the risk of death in patients exposed to compatible non-identical plasma compared to recipients of only identical plasma. RESULTS: After adjustment for potential confounding factors, there was an increased mortality associated with exposure to ABO-compatible non-identical plasma, with the excess risk mostly confined to those receiving 5 or more units (relative risk, 1.15; 95% confidence interval, 1.02-1.29). Stratification by blood group indicated higher risks in group O recipients, especially when the compatible plasma was from a group AB donor. CONCLUSIONS: This study suggests that ABO-compatible non-identical plasma is less safe than identical plasma. Subanalyses by blood group suggest a role for circulating immune complexes. Our findings may have policy implications for improving transfusion safety.
Authors: Deborah J Novak; Yu Bai; Rhonda K Cooke; Marisa B Marques; Magali J Fontaine; Jerome L Gottschall; Patricia M Carey; Richard M Scanlan; Eberhard W Fiebig; Ira A Shulman; Janice M Nelson; Sherri Flax; Veda Duncan; Jennifer A Daniel-Johnson; Jeannie L Callum; John B Holcomb; Erin E Fox; Sarah Baraniuk; Barbara C Tilley; Martin A Schreiber; Kenji Inaba; Sandro Rizoli; Jeanette M Podbielski; Bryan A Cotton; John R Hess Journal: Transfusion Date: 2015-03-30 Impact factor: 3.157
Authors: Majed A Refaai; Jessie Carter; Kelly F Henrichs; Donna C Davidson; Stephen J Pollock; Ann E Casey; Sherry L Spinelli; Richard P Phipps; Charles W Francis; Neil Blumberg Journal: Transfusion Date: 2012-05-25 Impact factor: 3.157
Authors: Majed A Refaai; Lawrence B Fialkow; Joanna M Heal; Kelly F Henrichs; Sherry L Spinelli; Richard P Phipps; Edward Masel; Brian H Smith; James P Corsetti; Charles W Francis; Paul E Bankey; Neil Blumberg Journal: Vox Sang Date: 2011-03-18 Impact factor: 2.144
Authors: Majed A Refaai; Kelly F Henrichs; Sherry L Spinelli; Richard P Phipps; Edward Masel; Brian H Smith; Charles W Francis; Neil Blumberg Journal: US Oncol Hematol Date: 2011-01-01
Authors: Gustaf Edgren; Mads Kamper-Jørgensen; Sandra Eloranta; Klaus Rostgaard; Brian Custer; Henrik Ullum; Edward L Murphy; Michael P Busch; Marie Reilly; Mads Melbye; Henrik Hjalgrim; Olof Nyrén Journal: Transfusion Date: 2010-02-12 Impact factor: 3.157
Authors: Steven L Spitalnik; Darrell Triulzi; Dana V Devine; Walter H Dzik; Anne F Eder; Terry Gernsheimer; Cassandra D Josephson; Daryl J Kor; Naomi L C Luban; Nareg H Roubinian; Traci Mondoro; Lisbeth A Welniak; Shimian Zou; Simone Glynn Journal: Transfusion Date: 2015-08-10 Impact factor: 3.157