Page 316 - Haematologica April 2020

Blood Transfusion
Ferrata Storti Foundation
Haematologica 2020 Volume 105(4):1158-1165
Transition from fresh frozen plasma to solvent/detergent plasma in the Netherlands: comparing clinical use and transfusion reaction risks
Nicholas H. Saadah,1,2,3 Martin R. Schipperus,3,4 Johanna C. Wiersum- Osselton,3,5 Marian G. van Kraaij,5,6 Camila Caram-Deelder,1,2 Erik A.M. Beckers,7 Anja Leyte,8 Jan M.M. Rondeel,9 Karen M.K. de Vooght,10 Floor Weerkamp,11 Jaap Jan Zwaginga12 and Johanna G. van der Bom1,2
1Jon J. van Rood Centre for Clinical Transfusion Research, Sanquin Research, Leiden; 2Deptartment of Clinical Epidemiology, Leiden University Medical Centre, Leiden;
3TRIP, National Hemovigilance & Biovigilance Office, Leiden; 4Haga Teaching Hospital, Department of Haematology, The Hague; 5Donor Affairs, Sanquin Blood Supply, Leiden; 6Department of Transfusion Medicine, Sanquin Blood Supply, Amsterdam; 7Department of Haematology, Maastricht University Medical Centre, Maastricht; 8Department of Clinical Chemistry, OLVG Location East, Amsterdam; 9Department of Clinical Chemistry, Isala Clinics, Zwolle; 10Department of Clinical Chemistry, University Medical Centre Utrecht, Utrecht; 11Department of Clinical Chemistry, Maasstad Hospital, Rotterdam and 12Department of Immunohaematology and Blood Transfusion, Leiden University Medical Centre, Leiden, the Netherlands
ABSTRACT
Plasma transfusion is indicated for replenishment of coagulative pro- teins to stop or prevent bleeding. In 2014, the Netherlands switched from using ~300mL fresh frozen plasma (FFP) units to using 200mL Omniplasma, a solvent/detergent treated pooled plasma (SD plasma), units. We evaluated the effect of the introduction of SD plasma on clin- ical plasma use, associated bleeding, and transfusion reaction incidences. Using diagnostic data from six Dutch hospitals, national blood bank data, and national hemovigilance data for 2011 to 2017, we compared the plasma/red blood cell (RBC) units ratio (f) and the mean number of plasma and RBC units transfused for FFP (~300mL) and SD plasma (200mL) for various patient groups, and calculated odds ratios comparing their associated transfusion reaction risks. Analyzing 13,910 transfusion episodes, the difference (∆f = fSD - fFFP) in mean plasma/RBC ratio (f) was negligible (∆fentire_cohort = 0.01 [95% confidence interval (CI): -0.02 - 0.05]; P=0.48). SD plasma was associated with fewer RBC units transfused per episode in gynecological (difference of mean number of units -1.66 [95% CI: -2.72, -0.61]) and aneurysm (-0.97 [-1.59, -0.35]) patients. SD plasma was further associated with fewer anaphylactic reactions than FFP (odds ratio 0.37 [0.18, 0.77; P<0.01]) while the differences for most transfusion reactions were not statistically significant. SD plasma units, despite being one third smaller in volume than FFP units, are not associated with a higher plasma/RBC ratio. SD plasma is associated with fewer anaphy- lactic reactions than FFP plasma/RBC units ratio.
Introduction
Plasma transfusion is indicated in a range of medical situations involving replen- ishment of coagulative proteins to stop or prevent bleeding (e.g. surgery, liver dis- ease), or removal of an insulting entity via plasma exchange (e.g. thrombotic thrombocytopenic purpura, hemolytic-uremic syndrome [TTP/HUS]).1,2 On January 1, 2014, Sanquin Blood Bank, the National Blood Bank of the Netherlands, replaced quarantined FFP units, with a volume of ~300mL, with SD plasma Omniplasma made by Octapharma from a pool of either ~600 or ~1200 apheresis plasma donations, whose units are exactly 200mL in volume. Omniplasma is made
Correspondence:
JOHANNA G. VAN DER BOM
j.g.van_der_bom@lumc.nl
Received: March 15, 2019. Accepted: June 26, 2019. Pre-published: July 4, 2019.
doi:10.3324/haematol.2019.222083
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