Evaluation of safety of using incompatible plasma for therapeutic plasma exchange during shortage of AB plasma.

Abstract

Criteria for selection of FFP blood type has not been clearly established and use of group AB plasma is preferred by numerous transplantation protocols. This study assesses the safety and efficacy of alternative group A or B plasma in ABO incompatible solid organ transplantation. Alternative use of group A or B plasma (incompatible plasma) was inevitable during the shortage of group AB plasma. Experience from select number of patients during the period of extreme group AB plasma shortage is described. The result of alternative use of group A or B plasma was within expectation, showing effective reduction of isoagglutinin titers for pre-operative desensitization and efficacy for treatment of post-operative patients. No immediate hemolytic transfusion reaction was reported. While validation in a larger cohort of patients is necessary, our limited experience have shown satisfactory clinical outcomes without adverse events. Use of incompatible group A or B plasma is a viable option when group AB plasma is limited.