Jansen N. Seheult, Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USAVitalant, Pittsburgh, Pennsylvania, USA
Nancy M. Dunbar, Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
John R. Hess, Department of Laboratory Medicine, University of Washington School of Medicine, Seattle, Washington, USA
Erin E. Tuott, Department of Laboratory Medicine, University of Washington School of Medicine, Seattle, Washington, USA
Mohammad Bahmanyar, Department of Pathology and Laboratory Medicine, Royal Columbian Hospital, New Westminster, British Columbia, Canada
Jessica Campbell, Department of Pathology and Laboratory Medicine, Wing-Kwai and Alice Lee-Tsing Chung Transfusion Service, David Geffen School of Medicine, UCLA (University of California, Los Angeles), Los Angeles, California, USA
Magali Fontaine, Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA
Jenna Khan, Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
Ara Ko, Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA
Jian Mi, Vancouver General Hospital, Vancouver, British Columbia, Canada
Michael F. Murphy, NHS Blood & Transplant, and Oxford Biomedical Research Centre, Oxford, UK
Tara Nykoluk, Department of Surgery, David Geffen School of Medicine, UCLA (University of California, Los Angeles), Los Angeles, California, USA
Jessica Poisson, Department of Pathology, Duke University, Durham, North Carolina, USA
Jay S. Raval, Department of Pathology, University of New Mexico, Albuquerque, New Mexico, USA
Andrew Shih, Vancouver General Hospital, Vancouver, British Columbia, Canada
Jason L. Sperry, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
Julie Staves, Vancouver General Hospital, Vancouver, British Columbia, Canada
Michelle Wong, Department of Pathology and Laboratory Medicine, Royal Columbian Hospital, New Westminster, British Columbia, Canada
Matthew T S Yan, Department of Pathology and Laboratory Medicine, Royal Columbian Hospital, New Westminster, British Columbia, Canada
Alyssa Ziman, Department of Pathology and Laboratory Medicine, Wing-Kwai and Alice Lee-Tsing Chung Transfusion Service, David Geffen School of Medicine, UCLA (University of California, Los Angeles), Los Angeles, California, USA
Mark H. Yazer, Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA Vitalant, Pittsburgh, Pennsylvania, USA

Document Type

Article

Publication Date

11-1-2020

Abstract

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.

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