Plasma transfusion in liver transplantation: a randomized, double‐blind, multicenter clinical comparison of three virally secured plasmas. Issue 6 (24th September 2012)

• Record Type: Journal Article
• Authors: Bartelmaos, Tonine; Chabanel, Anne; Léger, Julie; Villalon, Loïc; Gillon, Marie Christine; Rouget, Claude; Gomola, Alexandra; Denninger, Marie Hélène; Tardivel, René; Naegelen, Christian; Courtois, Françoise; Bardiaux, Laurent; Giraudeau, Bruno; Ozier, Yves
• Is Part Of: Transfusion. Volume 53:Issue 6(2013)
• Page Start: 1335
• Page End: 1345
• Publication Date: 2012-09-24
• Subjects: Hematology -- Periodicals; Blood -- Transfusion -- Periodicals; Blood Group Antigens -- Periodicals; Blood Preservation -- Periodicals; Blood Transfusion -- Periodicals; 615
• DOI: 10.1111/j.1537-2995.2012.03895.x
• Languages: English
• ISSNs: 0041-1132

Abstract

<abstract abstract-type="main" xml:lang="en"> <title> <x xml:space="preserve">Abstract</x> </title> <p> <bold>BACKGROUND:</bold> The clinical equivalence of plasma treated to reduce pathogen transmission and untreated plasma has not been extensively studied. A clinical trial was conducted in liver transplant recipients to compare the efficacy of three plasmas.</p> <p> <bold>STUDY DESIGN AND METHODS:</bold> A randomized, equivalence, blinded trial was performed in four French liver transplantation centers. The three studied (fresh‐frozen) plasmas were quarantine (Q‐FFP), methylene blue (MB‐FFP), and solvent/detergent (S/D‐FFP) plasmas. The primary outcome was the volume of plasma transfused during transplantation. Secondary outcomes included intraoperative blood loss, hemostasis variables corrections, and adverse events.</p> <p> <bold>RESULTS:</bold> One‐hundred patients were randomly assigned in the MB‐FFP, 96 in the S/D‐FFP, and 97 in the Q‐FFP groups, respectively. The median volumes of plasma transfused were 2254, 1905, and 1798 mL with MB‐FFP, S/D‐FFP, and Q‐FFP, respectively. The three plasmas were not equivalent. MB‐FFP was not equivalent to the two other plasmas, but S/D‐FFP and Q‐FFP were equivalent. The median numbers of transfused plasma units were 10, 10, and 8 units with MB‐FFP, S/D‐FFP, and Q‐FFP, respectively. Adjustment on bleeding risk factors diminished the difference between groups: the excess plasma volume transfused with MB‐FFP compared to Q‐FFP was reduced from 24% to 14%. Blood loss and coagulation factors corrections were not significantly different between the three arms.</p> <p> <bold>CONCLUSION:</bold> Compared to both Q‐FFP and S/D‐FFP, use of MB‐FFP was associated with a moderate increase in volume transfused, partly explained by a difference in unit volume and bleeding risk factors. Q‐FFP was associated with fewer units transfused than either S/D‐FFP or MB‐FFP.</p> </abstract>