Going from A to B: The safety of incompatible group A plasma for emergency release in trauma and massive transfusion patients

摘要

The second storm battering the AB plasma supply is the widespread adoption of massive transfusion protocols (MTPs), which advocate early and aggressive plasma resuscitation. In an informal poll of recent AABB annual meeting attendees, 93% had MTPs with fixed plasma:RBC ratios.4 Moreover, 73% maintain a thawed plasma inventory with most hospitals,,providing only AB plasma to patients without a current or historical ABO type. Because many trauma patients require transfer to large regional trauma centers, these patients are more likely to initially receive AB plasma due to the absence of a historical ABO type on file at the receiving facility.5 The direct consequence is overutilization of AB plasma since most patients will be group A, O, or B. In addition, the use of fixed plasma:RBC ratios often leads to plasma overtransfusion. In one study, 86% of transfused trauma patients did not meet the definition of massive transfusion, averaging only three RBC transfusions in the first 12 hours.