There was a suggestion at my facility to only thaw group A or B plasma for group O users, because someone thinks we outdate thawed group O plasma more than any other type. I would like to know what other Blood Bankers think of this?

My rebuttal was to just thaw 1 unit at a time instead of the current policy of 2 but keep it group specific. My thinking on staying with group specific is due to donor pools; recently there was a shortage of group B plasma.

I guess since more people are type O than otherwise, on the average, you would be using more O plasma when needed.  All things being equal as far as when a thawed unit is not given, that would mean that you should be tossing out more expired O. (Next would be A, then B, etc.)

 

Scott

Agreed with Smiller - we, as a lab waste a lot of FFP due to expiry so it's no skin off our nose to waste it thawed as to unthawed. It's a cheap product and (usually) not in that short a supply. We always issue group specific where available simply because we can.

 

Also using large volumes of none group plasma means that you are going to have to transfuse non-group blood in some cases and then you have the dilemma of at what point is it safe to switch to the patient's own group again. In a small remote lab we only held group AB FFB due to storage and expiry issues but if there was a major heamorrage protocol started the patient then HAD to be transfused blood appropriate to this course of action.

We always have thawed 4 AB, 4 O AND 4 A.

Since group A plasma is compatible with group O and group A patients, group A plasma will be compatible with ~ 85% of your patients (US Caucasian, but even higher % for other ethnic groups).  For that reason, I know of some places that do not even inventory or use group O plasma.  Looking at the efficacy of the products, since group A plasma has higher levels of Factor VIII than group O plasma, you're actually getting more bang for your buck by using group A plasma products for group O patients.  Group O red cell products would continue to be compatible with group O patients receiving group A plasma and group A and group O red cell products would continue to be compatible with group A patients receiving group A plasma.

 

If anyone is still trying to justify the use of 5 day thawed plasma, group A plasma at 5 days has higher FVIII levels than group O plasma at 24 hours. By using group A plasma at 5 days, the O patient is getting an equivalent or greater dose of FVIII than they would if they received group O plasma within 24 hours of thawing.  Have you ever had a physician ask what blood type the patient was before they determined how many plasma products they needed to order?

 

There were some interesting discussions at the AABB meeting about the routine use of group A plasma for massive transfusion protocols when the patient type is unknown but that's a whole other discussion topic.

My suggestion would be to thaw only 1 at a time, that will keep your waste down.

For MTPs we always thaw AB FFP for the first 2 because of a physician overreacting and calling an MTP when it is not really needed. At least this way we have the best shot at using it for another patient in the next 24 hours.

Thanks  for all the responses.

 

SMV- that was an interesting read.

 

  Looking at the efficacy of the products, since group A plasma has higher levels of Factor VIII than group O plasma, you're actually getting more bang for your buck by using group A plasma products for group O patients. 

We also thaw one unit at a time, unless it's MTP. That has cut our waste down dramatically.

We do not thaw anything until they submit a request for delivery, meaning they are ready to actually transfuse and then thaw group specific.  We waste very little.

We do not thaw anything until they submit a request for delivery, meaning they are ready to actually transfuse and then thaw group specific.  We waste very little.

 

Same here. No wastage.

Same here, we thaw on demand, only when they are ready to hang it, and one unit at a time.

Same here, we thaw on demand, only when they are ready to hang it, and one unit at a time.

Same as Terri. This has made a HUGE difference in the product we have wasted in the last year or two.

We keep 4 A plasma, 2 O plasma, 2 B plasma (5 day expiration). For O patient we try to give O unless emergency or A &/or B plasma has only 1 or 2 days left on it respectively.

 

Many time our suppliers can not provide A & B plasma and they are on back order!

 

In terms of inventory management also I feel like we should give O plasma to O patients.

 

We rarely expire any plasma since we went live with 5 day almost 8-9 year ago!!

 

& We do not keep any AB thawed plasma and our clinician knows that if the patient is AB there wil be a delay of 15-20 minutes.

Edited October 26, 201311 yr by Eagle Eye

We no longer stock any group O FFP/FP24, instead with thaw A's for the group patients.  We don't have much wastage, but this has helped to reduce waste even more.

We use bood group specific plasma, and we have not meet someone need plasma more urgently than 10 min, it is the time we thaw it.

If thansfuse non O plasma to O patient ,the soluble blood group substance ( I don't know if it is correct) will bind the antibodies ,and this kind of complex can damage the kidney.