Measurement of haemolysis markers following transfusion of uncrossmatched, low-titre, group O plus whole blood in civilian trauma patients: initial experience at a level 1 trauma centre

作者：Seheult J N; Triulzi D J; Alarcon L H; Sperry J L; Murdock A; Yazer M H^*

来源：Transfusion Medicine, 2017, 27(1): 30-35.

DOI：10.1111/tme.12372

• adverse events
• civilian
• haemolysis
• resuscitation
• transfusion
• trauma
• whole blood

Background/Objectives: The safety of administering uncross-matched, groupO, cold-stored, whole blood (cWB) during civilian trauma resuscitation was evaluated.
Methods/Materials: Male trauma patients with haemorrhage-induced hypotension who received leuko-reduced uncross-matched group O+, low titre (<50) anti-A and -B, platelet-replete cWB during initial resuscitation were included. The biochemical markers of haemolysis (lactate dehydrogenase, total bilirubin, haptoglobin, creatinine, serum potassium) were measured on the day of cWB receipt (day 0), and over the next 2 days, reports of transfusion reactions and total blood product administration in first 24 h of admission were recorded.
Results: There were 27 non-group O and 17 group O cWB recipients. The median number of cWB units transfused was 1 [interquartile range (IQR): 1-2] in both groups. Themedian day 0 post-transfusion serum total bilirubin concentration, although still in the normal range, was higher in the non-group O versus group O recipients (1.4 versus 0.5 mg/dL, P < 0.01). There were no significant differences in any of the other biochemical parameters at any other time point. Non-group O recipients received a median of 3 times more red blood cell (RBC) units compared with group O recipients (P = 0.01 RBCs), likely explaining the bilirubin difference on day 0. Themedian volume of ABO-incompatible plasma transfused to non-group O recipients was 600 mL (IQR: 300-1140 mL). There were no reports of adverse events related to the cWB transfusion in either group.
Conclusions: Administration of <= 2 units of cWB in civilian trauma resuscitation was not associated with clinically significant changes in laboratory haemolysis markers. Efficacy will be determined when larger quantities are transfused.

• 出版日期2017-2