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Basic Research in Plasma Medicine - A Throughput Approach from Liquids to Cells
Published on: November 17, 2017
Risks and side effects of therapy with plasma and plasma fractions
Sheila MacLennan1, John A J Barbara
1National Blood Service, Leeds Centre, Bridle Path, Leeds LS15 7TW, UK. sheila.maclennan@nbs.nhs.uk
Best Practice & Research. Clinical Haematology
|December 27, 2005
Summary
Plasma transfusions carry risks, including immune reactions and fluid overload. Pathogen reduction methods decrease viral transmission but may affect coagulation factors, while specific plasma products have unique adverse effects.
Area of Science:
- Transfusion Medicine
- Immunohaematology
- Biologics Safety
Background:
- Plasma transfusions are associated with various adverse reactions, primarily immune-mediated, ranging from mild to fatal.
- Risks include allergic reactions, transfusion-related acute lung injury (TRALI), hemolysis, fluid overload, and citrate toxicity.
- Microbial transmission risk is minimized in developed countries through donor screening and testing.
Purpose of the Study:
- To review the adverse reactions and risks associated with plasma transfusions and plasma-derived products.
- To discuss the impact and efficacy of pathogen reduction technologies.
- To outline specific risks associated with various plasma products and fractions.
Main Methods:
- Literature review of adverse events and safety data related to plasma transfusions.
- Analysis of pathogen reduction techniques (methylene blue, solvent-detergent) and their effects.
- Examination of safety profiles for specific plasma products like intravenous immunoglobulin and coagulation factors.
Main Results:
- Immune-mediated reactions (allergic, TRALI, hemolysis) are common, with severity varying widely.
- Pathogen reduction technologies further reduce viral transmission risk but can impact coagulation factors.
- Specific products carry distinct risks: IVIG with thrombotic events and renal toxicity; coagulation factors with inhibitor development.
Conclusions:
- Plasma transfusions and products present a spectrum of risks, necessitating careful management and monitoring.
- Pathogen reduction and viral inactivation steps significantly enhance safety, though some risks remain.
- Ongoing evaluation of risks, including unknown risks like variant Creutzfeldt-Jakob disease transmission, is crucial.
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