title: Comparative effectiveness of plasma prepared with amotosalen-UVA pathogen inactivation and conventional plasma for support of liver transplantation.
abstract: BACKGROUND
  Liver transplant may require large-volume plasma transfusion with increased risk of transfusion-transmitted infection (TTI). Pathogen inactivation of plasma with amotosalen-UVA offers the potential to mitigate TTI risk.
  
  
  METHODS
  A retrospective cohort design was used to compare the therapeutic efficacy and key safety outcomes for liver transplants supported with quarantine plasma (Q-FFP [reference]) or amotosalen-UVA plasma (IBS plasma [test]). The outcomes evaluated were volume of plasma, the numbers of red blood cell (RBC) components, and the total dose of platelets (PLTs) transfused during and 7 days after transplant. The safety outcomes were acute hepatic artery thrombosis (HAT) and mortality.
  
  
  RESULTS
  Transplantation and transfusion records for 212 Q-FFP transplants and 215 IBS plasma transplants were reviewed. Not all transplants required plasma; 161 received Q-FFP and 174 received IBS plasma. Among the transplants that required plasma, there were significant differences in median values between cohorts for delay to transplantation (p=0.002), model end-stage liver disease score (p<0.001), pretransplant hematocrit (p=0.006), and graft cold perfusion time (p=0.033). The median volumes of plasma transfused were not different for test and reference (2.160 L vs. 1.969 L, p=0.292). Transplants in the test cohort required a mean of 3.7% more RBC components (p=0.767) and on average a 16.5% increase in total PLT dose (p=0.518). No significant differences were observed for the frequency of acute HAT or mortality.
  
  
  CONCLUSIONS
  In this retrospective study, IBS plasma provided therapeutic support of liver transplant not different from Q-FFP.
authors: Pôle des Pathologies Digestives-Hépatiques-Transplantations, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
authors: Jacques
authors: J
authors: Cinqualbre
authors: EFS-Alsace, Strasbourg, France.
authors: Daniel
authors: D
authors: Kientz
authors: EFS-Alsace, Strasbourg, France.
authors: Emilie
authors: E
authors: Remy
authors: Cerus Corporation, Concord, California.
authors: Norman
authors: N
authors: Huang
authors: Cerus Corporation, Concord, California.
authors: Laurence
authors: L
authors: Corash
authors: Association ARMESA, Strasbourg, France.
authors: Jean Pierre
authors: JP
authors: Cazenave
mesh_terms: D000328:Adult; D016913:Blood Component Transfusion; D004203:Disinfection; D005260:Female; D011564:Furocoumarins / Q000494:pharmacology*; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D017319:Photosensitizing Agents / Q000494:pharmacology*; D010949:Plasma; D012189:Retrospective Studies; D014466:Ultraviolet Rays
chemical_list: D011564:Furocoumarins; D017319:Photosensitizing Agents; C118577:amotosalen