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Updated: Nov 16, 2025

Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
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MATRA-A: A study on massive transfusion.

Aytekin Ünlü1, Soner Yılmaz2, Izzet Turkalp Akbasli3

  • 1Department of General Surgery, Gulhane Traning and Research Hospital, Health Science University, Ankara, Turkey.

Vox Sanguinis
|February 26, 2021
PubMed
Summary
This summary is machine-generated.

Massive transfusions are critical in cardiovascular disease and trauma but linked to high mortality. A higher ratio of fresh frozen plasma to red blood cells in trauma patients may improve survival rates.

Keywords:
Turkeyindicationsmassive transfusionmortality

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Area of Science:

  • Critical care medicine
  • Transfusion medicine
  • Trauma surgery

Background:

  • Massive transfusion is employed in critical care but associated with high mortality.
  • Clinical scenarios necessitating massive transfusion require better definition.

Purpose of the Study:

  • To define the clinical circumstances and outcomes of massive transfusions.
  • To investigate the impact of component ratios on survival in trauma patients.

Main Methods:

  • A multicenter retrospective study (MATRA-A) was conducted.
  • Data from patients (>18 years) receiving massive transfusions (≥10 units/24h) between 2017-2019 were collected from six hospitals.
  • Clinical indications, transfusion components, and mortality rates were analyzed.

Main Results:

  • Massive transfusions were infrequent (0.27% of patients), with surgical patients receiving 90%.
  • Cardiovascular diseases (42.6%) and trauma (20.3%) were primary indications.
  • Overall mortality was 57.4%; trauma mortality was 61.8%. A higher fresh frozen plasma (FFP) to red blood cell (RBC) ratio (>1:1.5) in trauma patients was linked to significantly lower hospital mortality (47.6% vs. 86.6%, P=0.03).

Conclusions:

  • Massive transfusions are most common in cardiovascular disease and trauma, carrying high mortality risks.
  • A higher FFP:RBC ratio may enhance survival in massively transfused trauma patients.
  • Further prospective studies are needed to optimize massive transfusion protocols nationally.