BACKGROUND
Use of universally ABO‐compatible group AB plasma for trauma resuscitation can be challenging due to supply limitations. Many centers are now using group A plasma during the initial ...resuscitation of traumatically injured patients. This study was undertaken to evaluate the impact of this practice on mortality and hospital length of stay (LOS).
STUDY DESIGN AND METHODS
Seventeen trauma centers using group A plasma in trauma patients of unknown ABO group participated in this study. Eligible patients were group A, B, and AB trauma patients who received at least 1 unit of group A plasma. Data collected included patient sex, age, mechanism of injury, Trauma Injury Severity Score (TRISS) probability of survival, and number of blood products transfused. The main outcome of this study was in‐hospital mortality differences between group B and AB patients compared to group A patients. Data on early mortality (≤24 hr) and hospital LOS were also collected.
RESULTS
There were 354 B and AB patients and 809 A patients. The two study groups were comparable in terms of age, sex, TRISS probability of survival, and total number of blood products transfused. The use of group A plasma during the initial resuscitation of traumatically injured patients of unknown ABO group was not associated with increased in‐hospital mortality, early mortality, or hospital LOS for group B and AB patients compared to group A patients.
CONCLUSION
These results support the practice of issuing thawed group A plasma for the initial resuscitation of trauma patients of unknown ABO group.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
We report 2 patients who presented with vasomotor symptoms and severe thrombocytopenia following rattlesnake bites. These symptoms persisted in spite of treatment with antivenin and transfusion of ...multiple doses of platelets. Thrombocytopenia is a common occurrence in moderate to severe crotaline envenomation. Algorithms suggested for the treatment of rattlesnake envenomation with crotaline-specific antivenin may not reverse the associated thrombocytopenia. The precise mechanism of venom-induced thrombocytopenia (VIT), even in the absence of significant coagulopathy, is unknown. Our experience suggests that, unless spontaneous bleeding occurs, repeated transfusion of fresh frozen plasma and/or platelets may not be indicated.
To determine the appropriate target cell for assessment of anti-A titer in blood group B kidney transplant patients waiting for a deceased donor and qualify for blood group A2 (A subgroup) donors ...according to OPTN/UNOS guidelines.
248 sera samples collected from 57 blood group B candidates (56% male, 79% African American) and tested after DTT treatment. Titers were done using A1 and A2 reagent target cells using the MTS Gel anti-IgG card method. Standard commercial blood bank reagents were used for all testing (2 donors per lot of A1 or A2 cells). The same technologist performed all titers. The titer for eligibility is ⩽ 8.
37 patients were eligible (titer ⩽ 8) with either A1 or A2 cells. 20 patients (35%) shown below had titers from 16 up to 128 with A1 cells. 2(4%) patients had a titer >8 with A2 cells. Of these 20 patients, the cPRA varied from 0–100% and was not correlated with anti-A titer. Sex and race was also not correlated with an anti-A titer ⩾ 8.▪
Patient eligibility may vary considerably depending on the target cell used. Additional clinical studies will be required to determine the optimum approach.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
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