Transition from fresh frozen plasma to solvent/detergent plasma in the Netherlands:comparing clinical use and transfusion reaction risks
Plasma transfusion is indicated for replenishment of coagulative proteins to stop or prevent bleeding. In 2014, the Netherlands switched from using ~300mL fresh frozen plasma units to 200mL solvent/detergent plasma units. We evaluated the effect of the introduction of solvent/detergent plasma on clinical plasma use, associated bleeding, and transfusion reaction incidences. Using diagnostic data from six Dutch hospitals, national blood bank data, and national hemovigilance data for 2011-2017, we compared the plasma/RBC units ratio (f) and the mean number of plasma and RBC units transfused for f... Mehr ...
Plasma transfusion is indicated for replenishment of coagulative proteins to stop or prevent bleeding. In 2014, the Netherlands switched from using ~300mL fresh frozen plasma units to 200mL solvent/detergent plasma units. We evaluated the effect of the introduction of solvent/detergent plasma on clinical plasma use, associated bleeding, and transfusion reaction incidences. Using diagnostic data from six Dutch hospitals, national blood bank data, and national hemovigilance data for 2011-2017, we compared the plasma/RBC units ratio (f) and the mean number of plasma and RBC units transfused for fresh frozen plasma (~300mL) and solvent/detergent plasma (200mL) for various patient groups, and calculated odds ratios comparing their associated transfusion reaction risks. Analyzing 13,910 transfusion episodes, the difference (Δf = fSD - fFFP) in mean plasma/RBC ratio (f) was negligible (Δfentire_cohort = 0.01 [95% confidence interval (CI) -0.02 to 0.05]; p=0.48). Solvent/detergent plasma was associated with fewer RBC units transfused per episode in gynecological (difference of mean number of units -1.66 [95% CI: -2.72, -0.61]) and aneurysm (-0.97 [-1.59, -0.35]) patients. Solvent/detergent plasma was associated with fewer anaphylactic reactions than fresh frozen plasma (odds ratio 0.37 [0.18, 0.77; p<0.01]) while the differences for most transfusion reactions were not statistically significant. Solvent/detergent plasma units, despite being 1/3 smaller by volume than fresh frozen plasma units, are not associated with a higher plasma/RBC ratio. Solvent/detergent plasma is associated with fewer anaphylactic reactions than fresh frozen plasma.