Page 321 - Haematologica April 2020

Evaluating Netherlands’ transition from FFP to SD plasma
exchange (e.g. in TTP/HUS patients). By creating cohorts of transfusion episodes involving transfusion of both RBC and plasma units, we aimed to capture episodes where plasma was used in cases of active bleeding. The further stratification of these episodes by ward and diagnosis was intended to create progressively more homogeneous cohorts for comparison. If one plasma type more effec- tively stopped active bleeding than the other, we might
expect to observe a change in the mean number of RBC units transfused per episode with the switch to SD plas- ma.16 We observed such a change in the general surgery and gynecological groups, where the number of RBC units transfused alongside plasma was around half a unit (gen- eral surgery) and one unit (gynecology) lower for SD plas- ma than for FFP. Confounding our results, however, is the trend of decreased RBC transfusion within the
A
B
C
Figure 3. Blood product use prior to versus after the switch from fresh frozen plasma to solvent/detergent treated pooled plasma. (A) mean plasma units, (B) mean RBC units, and (C) mean plasma/RBC units ratio for FFP (thick black) and SD plasma (thick grey) along with mean differences (thin black) for all three values. Note that mean differences are calculated as meanSD - meanFFP such that a positive value indicates a higher value for SD plasma, and vice versa. CABG, VR, maze: coronary artery bypass graft, valve replacement, maze procedure; CT surg + card.:cardiothoracic surgery + cardiology; FFP: fresh frozen plasma; RBC: red blood cell; SD plas- ma: solvent/detergent treated pooled plasma.
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