(P-TS-97) Similarity in Transfusion Reaction Rates between Thawed Plasma and Thawed Solvent/Detergent Plasma

In 2016, solvent/detergent-treated plasma was validated post-thaw from 24 hours to 5 days (T-S/D) for routine use at this institution. Although prior studies evaluated the hemostatic effectiveness of thawed solvent/detergent (T-S/D) plasma compared to thawed plasma (TP) as well as the rates of transfusion reactions with S/D plasma, data regarding transfusion reactions to T-S/D was lacking. This retrospective study compares the rate of transfusion reactions with TP transfusions and T-S/D plasma. A focused examination of F5 deficient (F5D) patients, who are repeatedly transfused plasma, also was performed.

Study

Design/Methods:

Data on patients who received plasma between 2010 and 2023 were extracted from the institution’s electronic medical record and laboratory information system. Patients with transfusion reactions who received additional blood products within 6 hours of the plasma transfusion were excluded as transfusion reactions could not be directly attributed to the plasma product itself. The rate of transfusion reactions with each product was calculated per 1000 units transfused per 1000 patients and compared via chi-squared analysis.

Results/Findings:

From 2010 to 2023, 35,584 units of TP and 14,886 units of T-S/D were transfused with 7870 and 3013 patients transfused TP and T-S/D, respectively. During this time, 83 transfusion reactions were associated with TP, at a rate of 0.29/1000 units/1000 patients and 10 transfusion reactions were associated with T-S/D at a rate of 0.22/1000 units/1000 patients (p=0.41). To account for transfusion practice changes over time, the rate of reactions after 2017 were evaluated and found the rate due to TP was 0.43/1000 units/1000 patients and the rate due to T-S/D was 0.23/1000 units/1000 patients (p=0.24).

 When stratifying by transfusion reaction type during the overall study period of 2010-2023, (Figure 1) fewer allergic reactions (0.20/1000 units/1000 patients vs 0.24/1000 units/1000 patients, p=0.65) and febrile nonhemolytic reactions (0.02/1000 units/1000 patients versus 0.04/1000 units/1000 patients, p=0.73) were seen with T-S/D in comparison to TP. While 3 circulatory overload reactions were associated with TP during 2010-2023, none were associated with T-S/D.

 Of note, allergic reactions re-occurred in 2 of 3 patients with F5D. One patient had 3 allergic reactions to T-S/D and only 1 to TP while the other had 1 allergic reaction to T-S/D and 1 to TP. However, considering the number of units they were transfused, both patients had a decrease in their rates of reaction with T-S/D use from 1 per 50 to 1 per 100 and 1 per 333 to 1 per 1,000 units, respectively.

Conclusions:

This retrospective study shows a similar safety profile of T-S/D to TP. However, F5D individuals may exhibit a decrease in transfusion reactions when transfused with T-S/D.