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Safety profile of uncrossmatched, cold‐stored, low‐titer, group O+ whole blood in civilian trauma patients
Author(s) -
Seheult Jansen N.,
Bahr Marshall,
Anto Vincent,
Alarcon Louis H.,
Corcos Alain,
Sperry Jason L.,
Triulzi Darrell J.,
Yazer Mark H.
Publication year - 2018
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.14771
Subject(s) - medicine , hemolysis , abo blood group system , creatinine , resuscitation , titer , venipuncture , blood type (non human) , group b , adverse effect , whole blood , bilirubin , injury severity score , gastroenterology , anesthesia , emergency medicine , immunology , poison control , injury prevention , antibody
BACKGROUND The use of cold‐stored low‐titer group O whole blood (LTOWB) for civilian trauma patients is gaining popularity. However, hemolysis might occur among non–group O recipients. This study evaluated the serologic safety of transfusing up to 4 units of LTOWB. STUDY DESIGN AND METHODS Hypotensive male and at least 50‐year‐old female trauma patients who received leukoreduced, uncrossmatched, group O+, low‐titer (<50 anti‐A and anti‐B), platelet‐replete whole blood during initial resuscitation were included in this prospective, observational study. Biochemical markers of hemolysis were measured on the day of LTOWB receipt (Day 0) and over the next 2 days. Blood product administration in the first 24 hours of admission and reported transfusion‐associated adverse events were also reviewed. RESULTS There were 102 non–group O and 70 group O recipients of 1 to 4 LTOWB units analyzed. The non–group O recipients received a median volume of 600 mL (range, 300‐4100 mL) of ABO‐incompatible plasma, including the contribution from the LTOWB units. There were no significant differences in median haptoglobin, lactate dehydrogenase, total bilirubin, creatinine, or potassium levels at any time point between the non–group O and group O recipients. There were also no differences in these markers between the subset of 23 non–group O and 14 group O recipients who received 3 or 4 LTOWB units. No transfusion‐associated adverse events were reported. CONCLUSIONS Administration of up to 4 units of LTOWB in civilian trauma resuscitation was not associated with clinical or biochemical evidence of hemolysis. Six units per trauma patient are now permitted at these institutions.