title: Is group A thawed plasma suitable as the first option for emergency release transfusion? (CME).
abstract: BACKGROUND
  Group AB plasma, which lacks anti-A and anti-B isohemagglutinins, is issued for emergency transfusion when a patient's ABO group is unknown, but the relative scarcity of group AB blood donors limits its availability. We sought to establish a thawed plasma inventory to improve the rapid availability of plasma in the emergency release setting but were concerned about potential wastage of group AB plasma.
  
  
  METHODS
  Recognizing that plasma-incompatible apheresis platelets are routinely transfused and only rarely result in hemolytic reactions if the donor is blood group O, and considering that group A plasma would be compatible with approximately 85% of our patient population, we instituted an emergency release policy whereby thawed group A plasma is issued to all patients of unknown blood group or if compatible plasma is not available. ABO-compatible plasma is then issued, if needed, once the patient's blood group is determined. We prospectively assessed the outcomes of all patients who received incompatible plasma under our policy.
  
  
  RESULTS
  During the first 5 years under this policy, 385 emergency release requests for plasma were received by our blood bank. Among them, 23 group B or AB patients met criteria for receiving a median of 2 units of incompatible group A plasma. No hemolytic transfusion reactions or other adverse events related to transfusion were seen in any of these 23 patients.
  
  
  CONCLUSIONS
  We propose that group A plasma may be an acceptable alternative to AB plasma as the first option in the emergency release setting.
authors.affiliation: Division of Transfusion Medicine, UMass Memorial Medical Center, Worcester, Massachusetts; Department of Medicine, UMass Memorial Medical Center, Worcester, Massachusetts; Department of Pathology, UMass Memorial Medical Center, Worcester, Massachusetts; Transfusion Medicine Service, UMass Memorial Medical Center, Worcester, Massachusetts; University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Vishesh
authors.initials: V
authors.lastname: Chhibber
authors.forename: Mindy
authors.initials: M
authors.lastname: Greene
authors.forename: Michelle
authors.initials: M
authors.lastname: Vauthrin
authors.forename: Jeff
authors.initials: J
authors.lastname: Bailey
authors.forename: Robert
authors.initials: R
authors.lastname: Weinstein
mesh_terms: D000017:ABO Blood-Group System; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001771:Blood Banks / Q000592:standards; D001787:Blood Group Incompatibility / Q000453:epidemiology* / Q000209:etiology*; D001793:Blood Preservation; D001803:Blood Transfusion / Q000379:methods / Q000706:statistics & numerical data; D004632:Emergency Medical Services / Q000379:methods / Q000592:standards; D004638:Emergency Treatment / Q000009:adverse effects* / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D006461:Hemolysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D065227:Transfusion Reaction; D055815:Young Adult
chemical_list: D000017:ABO Blood-Group System