Hematology, Transfusion and Cell Therapy (Jul 2021)

Transfusion of ABO non-identical platelets increases the severity of trauma patients at ICU admission

  • Adriana Lucia de Oliveira Silva,
  • Lucas Bassolli,
  • Pedro Ferreira,
  • Edivaldo Utiyama,
  • Marcia Regina Dezan,
  • Abel Costa-Neto,
  • Marina C.A.V. Conrado,
  • Valeria Brito Oliveira,
  • Silvia Leão Bonifácio,
  • Frederico Leon Arrabal Fernandes,
  • Vanderson Rocha,
  • Alfredo Mendrone-Júnior,
  • Carla Luana Dinardo

Journal volume & issue
Vol. 43, no. 3
pp. 287 – 294

Abstract

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Background: Transfusion of ABO-compatible non-identical platelets (PTLs), fresh plasma (FP) and red blood cells (RBCs) has been associated with increased morbidity and mortality of recipients. Trauma victims are frequently exposed to ABO non-identical products, given the need for emergency transfusions. Our goal was to evaluate the impact of the transfusion of ABO non-identical blood products on the severity and all-cause 30-day mortality of trauma patients. Methods: This was a retrospective single-center cohort, which included trauma patients who received emergency transfusions in the first 24 h of hospitalization. Patients were divided in two groups according to the use of <3 or ≥3 ABO non-identical blood products. The patient severity, measured by the Acute Physiology and Chronic Health Evaluation (APACHEII) score at ICU admission, and the 30-day mortality were compared between groups. Results: Two hundred and sixteen trauma patients were enrolled. Of these, 21.3% received ≥3 ABO non-identical blood products (RBCs, PLTs and FP or cryoprecipitate). The transfusion of ≥3 ABO non-identical blood products in the first 24 h of hospitalization was independently associated with a higher APACHEII score at ICU admission (OR = 3.28 and CI95% = 1.48–7.16). Transfusion of at least one unit of ABO non-identical PTLs was also associated with severity (OR = 10.89 and CI95% = 3.38–38.49). Transfusion of ABO non-identical blood products was not associated with a higher 30-day mortality in the studied cohort. Conclusion: The transfusion of ABO non-identical blood products and, especially, of ABO non-identical PLTs may be associated with the greater severity of trauma patients at ICU admission. The transfusion of ABO non-identical blood products in the trauma setting is not without risks.

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