Universal pathogen-reduced plasma in elective open-heart surgery and liver resection.
ABO-incompatible transfusions and transfusion-related lung injury are today the leading transfusion-related causes of death in the developed world. Since anti-A and anti-B antibodies in plasma can give rise to serious, even fatal, transfusion reactions, ABO-identical/compatible plasma is indicated, but presents a logistical challenge and a risk for transfusion of incorrect plasma. In an effort to circumvent these problems, an ABO-independent universally applicable, pathogen-reduced plasma, Uniplas, has been developed and proven safe and efficacious for use in adults through prospective, randomized, controlled open-heart surgery studies and in prospective, parallel group, controlled liver resection studies. The results of these trials are presented and discussed in relation to solvent/detergent (SD) treated plasma, in general. The cost effectiveness of pathogen-reduced plasma is low because of the very low risk for transfusion transmitted viral infections in the developed world (US 2 to 9 million dollars per quality-adjusted life year). However, taking into account the combined safety of Uniplas with regard to transfusion-related lung injury, pathogen reduction and independence of ABO blood groups, the cost per gained life year is reduced to US 40,000 dollars to 100,000 dollars.
Solheim
Bjarte G
BG
Institute of Immunology, Rikshospitalet - Radiumhospitalet Medical Center, University of Oslo, NO-0027 Oslo, Norway. bjagees@online.no
D000017:ABO Blood-Group System / Q000276:immunology; D001803:Blood Transfusion / Q000379:methods*; D006348:Cardiac Surgical Procedures; D006801:Humans; D007518:Isoantibodies / Q000097:blood; D008099:Liver / Q000601:surgery; D055370:Lung Injury; D010949:Plasma / Q000276:immunology / Q000821:virology*; D012449:Safety; D065227:Transfusion Reaction
D000017:ABO Blood-Group System; D007518:Isoantibodies