Evaluation of safety of using incompatible plasma for therapeutic plasma exchange during shortage of AB plasma

Abstract

Background: Criteria for selection of FFP blood type has not been clearly established and use of group AB plasma is preferred by numerous transplantation protocols.

Aims: This study assesses the safety and efficacy of alternative group A or B plasma in ABO incompatible solid organ transplantation.

Materials & methods: Alternative use of group A or B plasma (incompatible plasma) was inevitable during the shortage of group AB plasma. Experience from select number of patients during the period of extreme group AB plasma shortage is described.

Results: The result of alternative use of group A or B plasma was within expectation, showing effective reduction of isoagglutinin titers for pre-operative desensitization and efficacy for treatment of post-operative patients. No immediate hemolytic transfusion reaction was reported.

Discussion: While validation in a larger cohort of patients is necessary, our limited experience have shown satisfactory clinical outcomes without adverse events.

Conclusions: Use of incompatible group A or B plasma is a viable option when group AB plasma is limited.

Keywords: desensitization; hemolysis; incompatible; plasma; safety; therapeutic plasma exchange.