title: Post-transfusion mortality among recipients of ABO-compatible but non-identical plasma.
abstract: OBJECTIVE
  The consequences of ABO-compatible non-identical plasma for patient outcome have not been studied in randomized clinical trials or large cohort studies and use varies widely in the absence of evidence-based policies. We investigated if transfusion with compatible instead of identical plasma confers any short-term survival disadvantage on the recipients.
  
  
  METHODS
  The cohort of all 86 082 Swedish patients who received their first plasma transfusion between 1990 and 2002 was followed for 14 days and the risk of death in patients exposed to compatible non-identical plasma compared to recipients of only identical plasma.
  
  
  RESULTS
  After adjustment for potential confounding factors, there was an increased mortality associated with exposure to ABO-compatible non-identical plasma, with the excess risk mostly confined to those receiving 5 or more units (relative risk, 1.15; 95% confidence interval, 1.02-1.29). Stratification by blood group indicated higher risks in group O recipients, especially when the compatible plasma was from a group AB donor.
  
  
  CONCLUSIONS
  This study suggests that ABO-compatible non-identical plasma is less safe than identical plasma. Subanalyses by blood group suggest a role for circulating immune complexes. Our findings may have policy implications for improving transfusion safety.
authors.affiliation: Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Shanwell
authors.forename: T M-L
authors.initials: TM
authors.lastname: Andersson
authors.forename: K
authors.initials: K
authors.lastname: Rostgaard
authors.forename: G
authors.initials: G
authors.lastname: Edgren
authors.forename: H
authors.initials: H
authors.lastname: Hjalgrim
authors.forename: R
authors.initials: R
authors.lastname: Norda
authors.forename: M
authors.initials: M
authors.lastname: Melbye
authors.forename: O
authors.initials: O
authors.lastname: Nyrén
authors.forename: M
authors.initials: M
authors.lastname: Reilly
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016913:Blood Component Transfusion / Q000401:mortality*; D001787:Blood Group Incompatibility / Q000276:immunology; D001804:Blood Transfusion, Autologous / Q000401:mortality; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010949:Plasma / Q000276:immunology*; D012044:Regression Analysis; D012306:Risk; D055815:Young Adult
chemical_list: D000017:ABO Blood-Group System