An international investigation into AB plasma administration in hospitals: how many AB plasma units were infused? The HABSWIN study

Abstract

BACKGROUND Typical practice is to transfuse group‐specific plasma units; however, there are situations where group AB plasma (universal donor) is issued to group A, B, or O recipients. If demand for group AB plasma exceeds collections, there is potential for shortage. This project explored the patterns of group AB plasma utilization at hospitals around the world. STUDY DESIGN AND METHODS The study had two phases: a survey that inquired about hospital group AB plasma inventory, policies, and transfusion practices and a retrospective review of 2014 calendar year data where participants submitted information on plasma disposition including ABO group of unit and recipient, transfusion location, and select indications. Recruitment occurred through snowball sampling. Descriptive analyses were performed. RESULTS Survey data were received from 25 centers across 10 countries; of those, 15 participants contributed to the data collection component. These 15 centers transfused a total of 43,369 AB plasma units during the study period. Only 1496 of 5541 (27%) group AB plasma units were transfused to group AB recipients. Transfusion policies, practices, and patterns were variable across sites. CONCLUSION Group AB plasma units are frequently transfused to non‐AB recipients. Whether transfusing 73% of group AB plasma units to non‐AB recipients is the ideal inventory management strategy remains to be determined.

Changes in plasma unit distributions to hospitals over a 10‐year period

“…When group AB plasma is thawed, perhaps in anticipation of use in an MTP, but not used, it can then be transfused to any other patient with a coagulopathy to avoid wastage. The results from a recent international retrospective investigation into group AB plasma transfusion practice in 15 hospitals indicated that group AB plasma was frequently transfused to non‐AB recipients, with only 27% of the group AB plasma units transfused to group AB recipients . Thus, supplying enough AB plasma to facilitate use in MTPs needs to be balanced against oversupplying this scarce resource such that it ends up being transfused to non–group AB patients to avoid wastage.…”

A regional massive hemorrhage protocol developed through a modified Delphi technique

“…60 The vast majority of AB plasma units are transfused to non-AB recipients. 61 Given the pressure on AB plasma stocks, it has not been possible to provide male-only AB plasma for all recipients, with resultant cases of transfusion-related acute lung injury from female AB plasma. 62 Hence, the draw of the group and screen sample, rapid transport of the sample to the laboratory and testing of the sample should be prioritized.…”

Plasma Isoagglutinin Depletion for Blood Group Independent Plasma Transfusion

“…However, as the prevalence for blood group AB in Germany is only about 6%, the access to AB plasma is limited despite targeted recruitment of AB plasma donors [ 5 ]. The need for AB plasma is consistently high as AB plasma is used as universal plasma and only 27% of AB plasma units transfused in 2014 in hospitals around the world were transfused to group AB recipients [ 6 ]. Three clinical situations are attractive for blood group independent transfusion of plasma.…”