Transfusion of blood components containing ABO-incompatible plasma does not lead to higher mortality in civilian trauma patients.
(Journal Article;Multicenter Study)
BACKGROUND: This study investigated the effect on mortality of transfusing ABO-incompatible plasma from all sources during trauma resuscitation. METHODS: Demographic, transfusion, and survival data were retrospectively extracted on civilian trauma patients. Patients were divided by receipt of any quantity of ABO-incompatible plasma from any blood product (incompatible group) or receipt of solely ABO-compatible plasma (compatible group). The primary outcome was 30-day mortality, while other outcomes included 6- and 24-hour mortality. Mixed-effects logistic regression was used to model the effect of various predictor variables, including receipt of incompatible plasma, on mortality outcomes. RESULTS: Nine hospitals contributed data on a total of 2618 trauma patients. There were 1282 patients in the incompatible group and 1336 patients in the compatible group. In both the unadjusted and adjusted models, the 6-hour, 24-hour, and 30-day mortality rates were not significantly different between these groups. The patients in the incompatible group were then divided into high volume (>342 mL) and low volume (≤342 mL) incompatible plasma recipients. In the adjusted model, the high-volume group had higher 24-hour mortality when the Trauma Injury Severity Score survival prediction was >50%. Mortality at 6 hours and 30 days was not higher in this model. The low-volume group did not have increased mortality at any of the time points in this adjusted model. CONCLUSION: The transfusion of incompatible plasma in civilian trauma resuscitation does not lead to higher 30-day mortality. The finding of higher mortality in a select group of recipients in the secondary analysis warrants further study.
Seheult, JN; Dunbar, NM; Hess, JR; Tuott, EE; Bahmanyar, M; Campbell, J; Fontaine, M; Khan, J; Ko, A; Mi, J; Murphy, MF; Nykoluk, T; Poisson, J; Raval, JS; Shih, A; Sperry, JL; Staves, J; Wong, M; Yan, MTS; Ziman, A; Yazer, MH; Biomedical Excellence for Safer Transfusion (BEST) collaborative,
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