title: Complications following an unnecessary peri-operative plasma transfusion and literature review.
abstract: Plasma is used to correct coagulopathies, but not all coagulation abnormalities are clinically significant enough to require correction before an invasive procedure. We report an 82-year-old female who, in response to a mildly prolonged INR of unknown etiology, was unnecessarily transfused with plasma in advance of elective surgery. The patient suffered a moderately severe transfusion reaction, including hives and voice hoarseness, which caused a 4-week delay in her surgery. This delay and adverse reaction could have been avoided had the principles of evidence based plasma therapy, which we herein review, been followed and if the etiology of the mildly elevated INR been investigated before the day of her surgery.
authors.affiliation: Department of Pathology, University of Pittsburgh Medical Center, Magee Women's Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA, USA ; The Institute for Transfusion Medicine, Magee Women's Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Jay S
authors.initials: JS
authors.lastname: Raval
authors.affiliation: Department of Anesthesiology, Magee Women's Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Jonathan H
authors.initials: JH
authors.lastname: Waters
authors.affiliation: Department of Pathology, University of Pittsburgh Medical Center, Magee Women's Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA, USA ; The Institute for Transfusion Medicine, Magee Women's Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Darrell J
authors.initials: DJ
authors.lastname: Triulzi
authors.affiliation: Department of Pathology, University of Pittsburgh Medical Center, Magee Women's Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA, USA ; The Institute for Transfusion Medicine, Magee Women's Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Mark H
authors.initials: MH
authors.lastname: Yazer
keywords: Allergic reaction; guidelines; plasma; transfusion