Marco Marietta1, Massimo Franchini2, M Lucia Bindi3, Francesco Picardi4, Matteo Ruggeri5, Giustina De Silvestro6. 1. Department of Oncology, Haematology and Respiratory Diseases, University Hospital, Modena, Italy. 2. Department of Haematology and Transfusion Medicine, "Carlo Poma" Hospital, Mantua, Italy. 3. Liver Transplant Anaesthesia and Critical Care Medicine, University Hospital "Nuovo Santa Chiara", Pisa, Italy. 4. Immunohaematology and Transfusion Medicine Service, "S. Salvatore" Hospital, Pesaro, Italy. 5. Postgraduate School of Health Economics and Management (Altems) and Istitute of Economic Policy, Catholic University of the Sacred Hearth, Roma, Italy. 6. Immunohaematology and Transfusion Medicine, University Hospital, Padua, Italy.
Abstract
BACKGROUND: Only a few studies have compared solvent/detergent plasma (SD-plasma) to standard fresh-frozen plasma (FFP) in terms of efficacy and safety. MATERIALS AND METHODS: A systematic review was performed in order to develop a consensus document on the use of SD-plasma. Moreover, a pharmacoeconomic study was performed in order to assess whether the use of SD-plasma can be cost-effective with respect to the use of FFP. A multidisciplinary panel used the systematic review and the GRADE methodology to develop evidence-based recommendations on this topic. RESULTS: Based on moderate to very low quality evidence, the panel developed the following consensus statements: (i) the panel suggested that SD-plasma is safer than FFP; (ii) the panel could not express for or against a greater efficacy of SD-plasma as compared to FFP; (iii) the panel suggested that in patients undergoing liver transplantation SD-plasma can be preferred over FFP; (iv) the panel suggested that SD-plasma can be preferred over FFP in patients with thrombotic thrombocytopenic purpura undergoing plasma-exchange procedures; (v) the panel could not recommend for or against preferring SD-plasma over FFP in critical care patients; and (vi) the panel suggested that the use of SD-plasma can be cost-effective with respect to the use of FFP. DISCUSSION: Data from additional randomised studies are needed to establish more definitive guidelines on the use of SD-plasma.
BACKGROUND: Only a few studies have compared solvent/detergent plasma (SD-plasma) to standard fresh-frozen plasma (FFP) in terms of efficacy and safety. MATERIALS AND METHODS: A systematic review was performed in order to develop a consensus document on the use of SD-plasma. Moreover, a pharmacoeconomic study was performed in order to assess whether the use of SD-plasma can be cost-effective with respect to the use of FFP. A multidisciplinary panel used the systematic review and the GRADE methodology to develop evidence-based recommendations on this topic. RESULTS: Based on moderate to very low quality evidence, the panel developed the following consensus statements: (i) the panel suggested that SD-plasma is safer than FFP; (ii) the panel could not express for or against a greater efficacy of SD-plasma as compared to FFP; (iii) the panel suggested that in patients undergoing liver transplantation SD-plasma can be preferred over FFP; (iv) the panel suggested that SD-plasma can be preferred over FFP in patients with thrombotic thrombocytopenic purpura undergoing plasma-exchange procedures; (v) the panel could not recommend for or against preferring SD-plasma over FFP in critical care patients; and (vi) the panel suggested that the use of SD-plasma can be cost-effective with respect to the use of FFP. DISCUSSION: Data from additional randomised studies are needed to establish more definitive guidelines on the use of SD-plasma.
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