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Universal Pathogen-Reduced Plasma in Elective Open-Heart Surgery and Liver Resection

机译:选择性开放心脏手术和肝切除术中的普遍病原体减少血浆

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摘要

ABO-incompatible transfusions and transfusion-related lung injury are today the leading transfusion-related causes of death in the developed world. Since anti-A and anti-B antibodies in plasma can give rise to serious, even fatal, transfusion reactions,ABO-identical/compatible plasma is indicated, but presents a logistical challenge and a risk for transfusion of incorrect plasma. In an effort to circumvent these problems,an ABO-independent universally applicable,pathogen-reduced plasma, Uniplas, has been developed and proven safe and efficacious for use in adults through prospective, randomized, controlled open-heart surgery studies and in prospective, parallel group, controlled liver resection studies.The results of these trials are presented and discussed in relation to solvent/detergent (SD) treated plasma, in general.The cost effectiveness of pathogen-reduced plasma is low because of the very low risk for transfusion transmitted viral infections in the developed world (US $2 to $9 million per quality-adjusted life year). However, taking into account the combined safety of Uniplas with regard to transfusion-related lung injury, pathogen reduction and independence of ABO blood groups, the cost per gained life year is reduced to US $40,000 to $100,000.
机译:与ABO不相容的输血和与输血有关的肺损伤是当今发达国家与输血有关的主要死亡原因。由于血浆中的抗A和抗B抗体会引起严重的甚至致命的输血反应,因此建议使用ABO相同/兼容的血浆,但存在逻辑上的挑战,并存在输注不正确血浆的风险。为了避免这些问题,已经开发了一种独立于ABO的,普遍适用的,可减少病原体的血浆Uniplas,并通过前瞻性,随机,对照的开放式心脏手术研究以及在前瞻性,平行研究中被证明对成人安全有效一般而言,这些试验的结果与溶剂/去污剂(SD)处理的血浆有关,并进行了讨论。由于减少了传播的输血风险,减少病原体的血浆的成本效益很低发达国家的病毒感染(每质量调整生命年2到900万美元)。但是,考虑到Uniplas在与输血相关的肺损伤,病原体减少和ABO血型独立性方面的综合安全性,每生命年的成本降低至40,000美元至100,000美元。

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