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Comparing transfusion reaction rates for various plasma types: a systematic review and meta‐analysis/regression
Author(s) -
Saadah Nicholas H.,
van Hout Fabienne M.A.,
Schipperus Martin R.,
le Cessie Saskia,
Middelburg Rutger A.,
WiersumOsselton Johanna C.,
van der Bom Johanna G.
Publication year - 2017
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.14245
Subject(s) - medicine , fresh frozen plasma , confidence interval , transfusion related acute lung injury , meta analysis , anesthesia , platelet , lung , pulmonary edema
BACKGROUND We estimated rates for common plasma‐associated transfusion reactions and compared reported rates for various plasma types. STUDY DESIGN AND METHODS We performed a systematic review and meta‐analysis of peer‐reviewed articles that reported plasma transfusion reaction rates. Random‐effects pooled rates were calculated and compared between plasma types. Meta‐regression was used to compare various plasma types with regard to their reported plasma transfusion reaction rates. RESULTS Forty‐eight studies reported transfusion reaction rates for fresh‐frozen plasma (FFP; mixed‐sex and male‐only), amotosalen INTERCEPT FFP, methylene blue‐treated FFP, and solvent/detergent‐treated pooled plasma. Random‐effects pooled average rates for FFP were: allergic reactions, 92/10 5 units transfused (95% confidence interval [CI], 46‐184/10 5 units transfused); febrile nonhemolytic transfusion reactions (FNHTRs), 12/10 5 units transfused (95% CI, 7‐22/10 5 units transfused); transfusion‐associated circulatory overload (TACO), 6/10 5 units transfused (95% CI, 1‐30/10 5 units transfused); transfusion‐related acute lung injury (TRALI), 1.8/10 5 units transfused (95% CI, 1.2‐2.7/10 5 units transfused); and anaphylactic reactions, 0.8/10 5 units transfused (95% CI, 0‐45.7/10 5 units transfused). Risk differences between plasma types were not significant for allergic reactions, TACO, or anaphylactic reactions. Methylene blue‐treated FFP led to fewer FNHTRs than FFP (risk difference = −15.3 FNHTRs/10 5 units transfused; 95% CI, −24.7 to −7.1 reactions/10 5 units transfused); and male‐only FFP led to fewer cases of TRALI than mixed‐sex FFP (risk difference = −0.74 TRALI/10 5 units transfused; 95% CI, −2.42 to −0.42 injuries/10 5 units transfused). CONCLUSION Meta‐regression demonstrates that the rate of FNHTRs is lower for methylene blue‐treated compared with FFP, and the rate of TRALI is lower for male‐only than for mixed‐sex FFP; whereas no significant differences are observed between plasma types for allergic reactions, TACO, or anaphylactic reactions. Reported transfusion reaction rates suffer from high heterogeneity.