Background/Case Studies: Only 4% of the population has a blood type of AB making the availability of AB plasma very limited. The Level I trauma site began thawing AB Plasma due to a concern that there would be delays for group B or AB patients during Massive Transfusion Protocol (MTP). The hospital system has been using group A plasma for trauma patients for over 5 years without incidence but one event where the blood type was known to be group B resulted in a slight delay as type-specific plasma was thawed. This event set off the request for group AB to be kept pre-thawed. Evidence needed to be gathered to show that the number of group B and AB MTP patients was not significantly higher than other Level I trauma center within the system that was only pre-thawing group A plasma.
Study
Design/Methods: Data for 2022 MTP events were evaluated, of the 37 MTP events there were 5 patients (13.5%) were group B or AB. The routine process was to automatically have 2 A and 2 AB plasma products pre-thawed which resulted in group AB being given unnecessarily 86.5% of the time. There was also a large number of units that were crossed over into routine inventory to be used so that the products did not go to waste. With only 4% of the population being AB, the majority were given to non-AB patients. The blood supplier was concerned that the site was using a high % of AB plasma ranging from 45.7 to 20.5% for the first 8 months of 2022.
Results/Findings: Data was gathered for other sites within the system, including 4 other Level I trauma locations, and found that most were closer to 13% for AB plasma orders. Data was taken to the site transfusion committee for review with a request to move to pre-thaw only group A and no longer pre-thaw any AB plasma products. The move to group A plasma was approved and implemented at the end of November 2022. There was a dramatic drop in AB plasma orders for December down to 3.8% (see Figure A). Conclusions: There was a dramatic decrease in the ordering of group AB plasma starting in the month of December 2022. There have been 11 MTP events in 2023 only 2 patients were found to be group B. Both came in as Unknown blood types and were given group A plasma until a type could be determined. Type-specific plasma was given as soon as the blood types were determined and there were no transfusion reactions or complications associated with the transfusions. Decreasing the use of AB plasma is extremely important as we continue to struggle with maintaining an appropriate inventory for those patients that have no other options but to receive group AB.
Importance of research: Only 4% of the population has a blood type of AB making the availability of AB plasma very limited. This abstract presents data on how a level 1 trauma center decreases AB plasma utilization. Decreasing the use of AB plasma is extremely important as we continue to struggle with maintaining an appropriate inventory for patients that have no other options but to receive group AB.
