Universal fresh-frozen plasma (Uniplas): an exploratory study in adult patients undergoing elective liver resection.
OBJECTIVE
The compatibility of an ABO blood group independently applicable plasma, Uniplas, was explored in liver resection because patients undergoing liver resection frequently require the transfusion of plasma to compensate for blood loss and/or clotting factors.


METHODS
One-hundred and twenty two patients undergoing elective liver resection were enrolled; 81 patients required plasma transfusion, while 41 did not. Of those in need of plasma, 58 were blood group A, B or AB, and 23 were blood group O. Patients were monitored up to day 7 postoperatively for signs of haemolysis and haemostasis, and viral markers were assessed at baseline and 3 weeks postoperatively.


RESULTS
Uniplas transfusions of up to 50.7 ml/kg body weight were given per treatment episode, without signs of haemolysis caused by transfusion. A total of 94/99 patients (95%) were negative in the direct antiglobulin test throughout the study. Two patients, one transfused with Uniplas, the other not, had a positive direct antiglobulin test result at baseline, while three of 64 patients transfused with Uniplas demonstrated a change from having negative to intermittently positive direct antiglobulin test results without concurrent signs of haemolysis. International normalized ratio, activated partial thromboplastin time and protein C levels were maintained by transfusion of plasma (>/= 20 ml/kg body weight). No patient underwent seroconversion for human immunodeficiency virus, hepatitis B virus or hepatitis C virus. Positivity for hepatitis A virus (HAV) immunoglobulin G (IgG) in 11 patients from the Uniplas group (who tested HAV immunoglobulin M negative), together with an apparent seroconversion for parvovirus B19 seen in two patients who received Uniplas, indicated passively transferred IgG antibodies.


CONCLUSIONS
No haemolysis was observed as a result of Uniplas transfusions up to 50.7 ml/kg body weight per treatment episode in patients undergoing liver resection. Moreover, transfusion (>/= 20 ml/kg body weight of Uniplas) maintained acceptable levels of international normalized ratio, activated partial thromboplastin time and protein C.
Solheim
B G
BG
Institute of Immunology, Rikshospitalet University Hospital, University of Oslo, Oslo, Norway. bjarte.solheim@rikshospitalet.no
Granov
D A
DA
Juravlev
V A
VA
Krawczyk
M
M
Kubishkin
V A
VA
Patutko
U I
UI
Raab
R
R
D000017:ABO Blood-Group System; D000328:Adult; D000368:Aged; D016913:Blood Component Transfusion / Q000009:adverse effects; D003165:Complement System Proteins / Q000032:analysis; D017558:Elective Surgical Procedures; D005260:Female; D006461:Hemolysis; D006487:Hemostasis; D006801:Humans; D019934:International Normalized Ratio; D008099:Liver / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010949:Plasma; D011486:Protein C / Q000032:analysis; D014227:Triazines
D000017:ABO Blood-Group System; D011486:Protein C; D014227:Triazines; C053507:4-azido-7-phenylpyrazolo-(1,5a)-1,3,5-triazine; D003165:Complement System Proteins