Comparing transfusion reaction rates for various plasma types: a systematic review and meta-analysis/regression

作者：Saadah Nicholas H; van Hout Fabienne M A; Schipperus Martin R; le Cessie Saskia; Middelburg Rutger A; Wiersum Osselton Johanna C; van der Bom Johanna G^*

来源：Transfusion, 2017, 57(9): 2104-2114.

DOI：10.1111/trf.14245

BACKGROUNDWe estimated rates for common plasma-associated transfusion reactions and compared reported rates for various plasma types.
STUDY DESIGN AND METHODSWe 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.
RESULTSForty-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).
CONCLUSIONMeta-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.

• 出版日期2017-9