Post-transfusion mortality among recipients of ABO-compatible but non-identical plasma
Article first published online: 24 FEB 2009
© 2009 The Author(s). Journal compilation © 2009 International Society of Blood Transfusion
Volume 96, Issue 4, pages 316–323, May 2009
How to Cite
Shanwell, A., Andersson, T. M.-L., Rostgaard, K., Edgren, G., Hjalgrim, H., Norda, R., Melbye, M., Nyrén, O. and Reilly, M. (2009), Post-transfusion mortality among recipients of ABO-compatible but non-identical plasma. Vox Sanguinis, 96: 316–323. doi: 10.1111/j.1423-0410.2009.01167.x
- Issue published online: 14 APR 2009
- Article first published online: 24 FEB 2009
- Received: 29 October 2008, revised 11 January 2009, accepted 18 January 2009, published online 24 February 2009
- ABO match;
- blood group;
- circulating immune complexes;
- short-term survival;
- transfusion safety
Background and Objectives The consequences of ABO-compatible non-identical plasma for patient outcome have not been studied in randomized clinical trials or large cohort studies and use varies widely in the absence of evidence-based policies. We investigated if transfusion with compatible instead of identical plasma confers any short-term survival disadvantage on the recipients.
Materials and Methods The cohort of all 86 082 Swedish patients who received their first plasma transfusion between 1990 and 2002 was followed for 14 days and the risk of death in patients exposed to compatible non-identical plasma compared to recipients of only identical plasma.
Results After adjustment for potential confounding factors, there was an increased mortality associated with exposure to ABO-compatible non-identical plasma, with the excess risk mostly confined to those receiving 5 or more units (relative risk, 1·15; 95% confidence interval, 1·02–1·29). Stratification by blood group indicated higher risks in group O recipients, especially when the compatible plasma was from a group AB donor.
Conclusions This study suggests that ABO-compatible non-identical plasma is less safe than identical plasma. Subanalyses by blood group suggest a role for circulating immune complexes. Our findings may have policy implications for improving transfusion safety.