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Universal Pathogen-Reduced Plasma in Elective Open-Heart Surgery and Liver Resection

Bjarte G. Solheim, MD, PhD, MHA, Institute of Immunology, Rikshospitalet – Radiumhospitalet Medical Center, University of Oslo, NO-0027 Oslo, Norway

Reprint Requests: Bjarte G. Solheim, MD, PhD, MHA, Institute of Immunology, Rikshospitalet – Radiumhospitalet Medical Center, University of Oslo, NO-0027 Oslo, Norway. Tel.: +47 2307 3007, Fax: +47 2307 3510, E-mail: bjagees{at}online.no

ABO-incompatible transfusions and transfusion-related lung injury are today the leading transfusion-related causes of death in the developed world. Since anti-A and anti-B antibodies in plasma can give rise to serious, even fatal, transfusion reactions,ABO-identical/compatible plasma is indicated, but presents a logistical challenge and a risk for transfusion of incorrect plasma. In an effort to circumvent these problems,an ABO-independent universally applicable,pathogen-reduced plasma, Uniplas, has been developed and proven safe and efficacious for use in adults through prospective, randomized, controlled open-heart surgery studies and in prospective, parallel group, controlled liver resection studies.The results of these trials are presented and discussed in relation to solvent/detergent (SD) treated plasma, in general.

The cost effectiveness of pathogen-reduced plasma is low because of the very low risk for transfusion transmitted viral infections in the developed world (US $2 to $9 million per quality-adjusted life year). However, taking into account the combined safety of Uniplas with regard to transfusion-related lung injury, pathogen reduction and independence of ABO blood groups, the cost per gained life year is reduced to US $40,000 to $100,000.

Key Words: ABO blood-group system • Universal ABO-independent plasma • Pathogen reduction • Blood transfusion • Open-heart surgery • Liver resection • Cost-effectiveness