Evaluation of A plasma for incompatible patients.

Area of Science:

• Transfusion Medicine
• Immunology
• Hematology

Background:

• Plasma transfusion is vital for bleeding patients, but AB plasma scarcity necessitates alternatives.
• Using A plasma for B and AB patients in emergencies is increasing, requiring safety evaluation.
• Hemolytic transfusion reactions, including subclinical hemolysis, are underreported.

Purpose of the Study:

• To evaluate the safety of using A plasma in B and AB patients.
• To determine the incidence of immune-mediated hemolysis following A plasma transfusion.
• To assess the impact on mortality and intensive care unit (ICU) length of stay.

Main Methods:

• Retrospective study of 93 B and AB patients receiving ≥1 unit of A plasma.
• Chart review for demographics, mortality, ICU stay, and hemolysis markers.
• Primary endpoints: immune-mediated hemolysis, mortality, and ICU length of stay.

Main Results:

• No evidence of ABO immune-mediated hemolysis was detected.
• One delayed hemolytic reaction occurred, unrelated to ABO incompatibility.
• A weak association between A plasma volume and mortality/ICU stay was noted.

Conclusions:

• A plasma transfusion is safe for B and AB patients, with no observed ABO hemolysis.
• The study supports the clinical use of A plasma in emergencies.
• Disease severity may explain the observed relationship between A plasma volume and outcomes.