Impact of fresh frozen plasma transfusion on postoperative inflammation and prognosis of colorectal liver metastases

Transfusion reactions associated with COVID‐19 convalescent plasma therapy for SARS‐CoV‐2

“…Given the large overlap in symptoms, distinguishing FNHTR from COVID‐associated fever will likely remain a challenge with the use of CP going forward. In a similar vein, evidence has shown that there can be longer‐term adverse events to blood product transfusion that occur beyond the time frames established by the CDC NHSN criteria 38–40 . Thus, it is possible that other complications of CP transfusion may not have been identified by our study.…”

“…In a similar vein, evidence has shown that there can be longer-term adverse events to blood product transfusion that occur beyond the time frames established by the CDC NHSN criteria. [38][39][40] Thus, it is possible that other complications of CP transfusion may not have been identified by our study. Identification of such associations require far larger studies than conducted here to account for the myriad confounding variables that would be present in the COVID-19 patient population.…”

“…While it is not surprising to speculate that patients with more severe disease are more likely to develop transfusion reactions due to their higher baseline inflammatory state, our findings showing no association with cytokine levels such as IL‐6, IL‐1β, or TNFα raises questions. One possibility might be that patients with more severe disease are more susceptible to potential transfusion‐related immunomodulatory effects, a phenomenon traditionally associated with red blood cells, but with evidence for its existence in plasma transfusion as well 40,56 . Studies demonstrate decreased levels of IL‐1β, IL‐8, and TNFα secretion by monocytes in vitro when exposed to FFP as compared to spray‐dried detergent‐treated plasma, raising the possibility of immunomodulatory effects of plasma itself, 56 while another study reported decreased inflammatory markers, poorer overall survival, and increased metastatic disease in a study of patients with colorectal cancer receiving FFP during their hospital stay 40 .…”

“…One possibility might be that patients with more severe disease are more susceptible to potential transfusion-related immunomodulatory effects, a phenomenon traditionally associated with red blood cells, but with evidence for its existence in plasma transfusion as well. 40,56 Studies demonstrate decreased levels of IL-1β, IL-8, and TNFα secretion by monocytes in vitro when exposed to FFP as compared to spray-dried detergent-treated plasma, raising the possibility of immunomodulatory effects of plasma itself, 56 while another study reported decreased inflammatory markers, poorer overall survival, and increased metastatic disease in a study of patients with colorectal cancer receiving FFP during their hospital stay. 40 It is possible that plasma transfusion causes a blunted innate immune response, thereby increasing clinical manifestations of underlying COVID-19 in patients with a higher SOFA score.…”

“…40,56 Studies demonstrate decreased levels of IL-1β, IL-8, and TNFα secretion by monocytes in vitro when exposed to FFP as compared to spray-dried detergent-treated plasma, raising the possibility of immunomodulatory effects of plasma itself, 56 while another study reported decreased inflammatory markers, poorer overall survival, and increased metastatic disease in a study of patients with colorectal cancer receiving FFP during their hospital stay. 40 It is possible that plasma transfusion causes a blunted innate immune response, thereby increasing clinical manifestations of underlying COVID-19 in patients with a higher SOFA score. The overall characterization of CP, including concentration of these potentially immunomodulatory factors, is currently unknown and is an area warranting further study.…”