Multicenter Comparison of Emergency Release Group A versus AB Plasma in Blunt-Injured Trauma Patients

Abstract

INTRODUCTION Group AB plasma, the traditional universal donor plasma product, is a limited resource. We compared outcomes of Group A plasma transfusion in comparison to AB. METHODS Analysis of blunt-injured patients who received emergency release plasma from was performed. Multivariable logistic regression was utilized to identify associations with morbidity and mortality. RESULTS There were 191 patients; 115 Group A and 76 Group AB. No differences were seen in age, sex, plasma transfusions, uncrossmatched red blood cells (RBCs), and Glasgow Coma Scale (GCS). Patients who received Group A plasma had significantly lower Injury Severity Score, chest Abbreviated Injury Scale, and scene transfer rate but not head AIS, or abdomen AIS. In addition, significant differences were noted in terms of blood products transfused within 24 hours in those receiving Group A over AB. Development of acute respiratory distress syndrome (ARDS), but not mortality, was higher within the AB cohort. No hemolytic or transfusion associated-ARDS reactions were noted in either group. ARDS; RBC transfusion volumes and head AIS were independently associated with mortality. CONCLUSION Utilization of Group A plasma for emergency blood resuscitation is a safe option which may alleviate potential shortages of AB plasma.

Safety of the use of group A plasma in trauma: the STAT study

“…Despite most (76%) of the participating centers not measuring anti‐B titers in group A plasma units before release, there were no reported acute hemolytic transfusion reactions attributable to ABO incompatibility. Thus it appears safe to utilize group A plasma as the first option for trauma patients of unknown ABO group, a finding consistent with, and confirmatory of, those of recent smaller studies . The safety of transfusing plasma that is ABO compatible but not identical (such as group A plasma to a group O recipient) has been questioned but could not be answered in this study as group O recipients were excluded from analysis .…”

“…The use of group A plasma for trauma patients of unknown blood group has previously been proposed as an alternative to group AB . A recently published survey revealed that the use of group A plasma in the initial resuscitation of trauma patients of unknown ABO group is becoming a widespread practice in the United States .…”

Optimal Fluid Therapy for Traumatic Hemorrhagic Shock

“…92 Based on limited retrospective data, the emergency use of type A plasma appears safe. 93,94,95 As this practice becomes widespread, 96 more accurate data about the safety profile of this practice will soon become available.…”

Low titer A plasma in three AB patients for therapeutic plasma exchange

“…Use of A group plasma for patients with unknown ABO type has gained a wide acceptance and application for resuscitation purposes in the past decade …”

“…Use of A group plasma for patients with unknown ABO type has gained a wide acceptance and application for resuscitation purposes in the past decade. [1][2][3][4] It is part of massive transfusion protocols (MTPs) and its use mitigates the scarcity of AB plasma as only 4% of our donor population is AB type. 5 In addition, this approach has been shown to be safe for initial resuscitation of trauma patients of unknown ABO group.…”