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15 March 2017


Some hospitals are conducting massive blood transfusions with excessive reliance on fresh frozen plasma, researchers have claimed.

Dr Daniel Dante Yeh of Massachusetts General Hospital, USA, and colleagues examined the use of a blood transfusion method that is widely used but has previously only been studied in patients with severe traumatic injuries.

Dr Yeh said: 'The strategy of giving patients requiring massive transfusion greater amounts of fresh frozen plasma, relative to the amount of red blood cells, has spilled over from trauma patients into unstudied patient populations. This may have important consequences, since our results suggest that certain populations may be harmed by this practice.'

The study involved analysing figures covering all 865 massive transfusions administered at the Massachusetts General Hospital from 2009 to 2012. Of these, 767 were given to non-trauma patients. Survival was similar regardless of the ratios of fresh frozen plasma to red blood cells.

The study was published last Wednesday (8 March) in JAMA Surgery. It suggests that this practice may be harmful to some patients, and the authors call for urgent research in this area.

Dr Yeh says: 'Avoiding unnecessary fresh frozen plasma transfusion is important because there have been reports that associated the use of excess fresh frozen plasma with worse outcomes among patients that required less-than-massive transfusions.

'Similar studies now need to be performed in non-trauma patients before the approach can be accepted as standard practice here and elsewhere.'

Mesar, T. et al. Association of ratio-based massive transfusion with survival among patients without trauma. JAMA Surgery 8 March 2017; doi: 10.1001/jamasurg.2017.0098


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