Transfusion of ABO non-identical platelets increases the severity of trauma patients at ICU admission

• Main Authors: Adriana Lucia de Oliveira Silva, Lucas Bassolli, Pedro Ferreira, Edivaldo Utiyama, Marcia Regina Dezan, Abel Costa-Neto, Marina C.A.V. Conrado, Valeria Brito Oliveira, Silvia Leão Bonifácio, Frederico Leon Arrabal Fernandes, Vanderson Rocha, Alfredo Mendrone-Júnior, Carla Luana Dinardo
• Format: Article
• Language: English
• Published: Elsevier 2021-07-01
• Series: Hematology, Transfusion and Cell Therapy
• Subjects: Abo; Non identical; Transfusion; Trauma; Platelets
• Online Access: http://www.sciencedirect.com/science/article/pii/S2531137920301048

Background: Transfusion of ABO-compatible non-identical platelets (PTLs), fresh plasma (FP) and red blood cells (RBCs) has been associated with increased morbidity and mortality of recipients. Trauma victims are frequently exposed to ABO non-identical products, given the need for emergency transfusions. Our goal was to evaluate the impact of the transfusion of ABO non-identical blood products on the severity and all-cause 30-day mortality of trauma patients. Methods: This was a retrospective single-center cohort, which included trauma patients who received emergency transfusions in the first 24 h of hospitalization. Patients were divided in two groups according to the use of <3 or ≥3 ABO non-identical blood products. The patient severity, measured by the Acute Physiology and Chronic Health Evaluation (APACHEII) score at ICU admission, and the 30-day mortality were compared between groups. Results: Two hundred and sixteen trauma patients were enrolled. Of these, 21.3% received ≥3 ABO non-identical blood products (RBCs, PLTs and FP or cryoprecipitate). The transfusion of ≥3 ABO non-identical blood products in the first 24 h of hospitalization was independently associated with a higher APACHEII score at ICU admission (OR = 3.28 and CI95% = 1.48–7.16). Transfusion of at least one unit of ABO non-identical PTLs was also associated with severity (OR = 10.89 and CI95% = 3.38–38.49). Transfusion of ABO non-identical blood products was not associated with a higher 30-day mortality in the studied cohort. Conclusion: The transfusion of ABO non-identical blood products and, especially, of ABO non-identical PLTs may be associated with the greater severity of trauma patients at ICU admission. The transfusion of ABO non-identical blood products in the trauma setting is not without risks.