Solvent/detergent treated pooled human plasma can decrease the recurrence of allergic transfusion reactions in pediatric, adolescent, and young adult patients

Abstract

BackgroundOctaplas is a solvent/detergent (S/D)‐treated pooled human plasma indicated for the treatment of thrombotic thrombocytopenic purpura (TTP) as well as multiple coagulation factor deficiency in patients with liver disease or undergoing liver transplantation or cardiac surgery. We aimed at providing pediatric, adolescent, and young adult evidence for the decrease in allergic transfusion reactions (ATRs) with S/D‐treated plasma.Study Design/MethodsA single‐center retrospective review of patient records was performed from January 2018 through July 2022 for patients who received S/D treated plasma (Octaplas™; Octapharma).Results/FindingsA total of 1415 units of S/D‐treated plasma were transfused to nine patients at our institution. Patient ages ranged from 13 months to 25 years old. The reason to initiate transfusion with S/D treated plasma in six patients was mild to severe ATR to plasma‐containing products and the need for therapeutic plasma exchange (TPE) or plasma transfusions (PTs). TPE or PT was performed for various clinical indications. Average S/D treated plasma volume per TPE or PT ranged from 200 to 1800 mL per event. During the study period, since initiating transfusions with S/D treated plasma, there have been no allergic or other transfusion reactions reported among these patients.ConclusionWe have successfully utilized S/D treated plasma over the last 4.5 years for pediatric, adolescent, and young adult patients who otherwise would have suffered ATR due to necessary TPE or PT. S/D treated plasma is an additional tool that can be utilized by transfusion services, including pediatrics, to safely transfuse their patients.

Thirty years of experience with solvent/detergent‐treated plasma for transfusion medicine

“…Octaplas/octaplasLG efficacy and safety has been established in a range of critical indications in pediatric patients (Table 4). 32,33,[62][63][64][65][66][67] Use of octaplas for TPE was studied in a retrospective analysis of 324 TPE treatments in 35 pediatric patients (<18 years; mean age 12.3 years); of these, 24 (70.6%) had a malignant disease and 23 (67.6%) received allogeneic cell transplantations. Indications for TPE were methotrexate removal due to renal insufficiency or autoantibody-related disease (TTP or Guillain-Barré syndrome), acute or chronic GVHD, multi-organ failure, or rare indications such as high myoglobin due to rhabdomyolysis.…”

“…66 S/D plasma is also effective and well tolerated in critically ill neonates and pediatric patients. 32,33,[62][63][64][65][66][67] In 419 pediatric intensive care unit (ICU) patients with critical indications such as massive/minor bleeding, planned high-risk procedure, or high postoperative bleeding risk, the median INR reduction over 24 h was comparable between S/D plasma and FFP. 62 Moreover, octaplas demonstrated significant ICU mortality reductions versus FFP (p = .02).…”