Incompatible Type A Plasma Transfusion in Patients Requiring Massive Transfusion Protocol: Outcomes of an EAST Multicenter Study.

With a relative shortage of type AB plasma, many centers have converted to type A plasma for resuscitation of patients whose blood type is unknown. The goal of this study is to determine outcomes for trauma patients who received incompatible plasma transfusions as part of a massive transfusion protocol (MTP). Methods: As part of an EAST multi-institutional trial, registry and blood bank data were collected from 8 trauma centers for trauma patients (age >= 15 years) receiving emergency release plasma transfusions as part of MTPs from January 2012 - August 2016. Incompatible type A plasma was defined as transfusion to patient blood type B or AB. Results: Of the 1536 patients identified, 92% received compatible plasma transfusions and 8% received incompatible type A plasma. Patient characteristics were similar except for greater penetrating injuries (48% vs. 36%, p=.01) in the incompatible group. In the incompatible group, patients were transfused more plasma units at 4 hours (median 9 vs. 5, p<.001 and overall for stay vs. p=".03)." no hemolytic transfusion reactions were reported. two trali events reported in the compatible group. between incompatible groups there was difference rates of ards thromboembolic sepsis or acute renal failure mortality at hours days discharge similar groups. multivariate regression demonstrated that iss older age more rbc independently associated with death predictors morbidity. not an independent determinant conclusion: type a plasma to blood b ab appears relatedly transfusions as part mtp. level evidence: iii study type: therapeutic lippincott williams wilkins inc.>

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