Expert study on massive transfusion recipients and ABO-incompatible FFP

Outcomes of adult massive transfusion recipients administered ABO-incompatible fresh frozen plasma (FFP) from the Australian and New Zealand Massive Transfusion Registry have recently been published. The cohort included predominantly non-trauma patients for which studies are lacking.

Historically, group AB ‘universal’ plasma components (which don’t contain anti-A or anti-B) have been used during critical bleeding emergencies prior to determination of the patient’s ABO group. AB is the least prevalent ABO group (only around 4% of Australian donors), which places strain on supply and hospital inventories. Clinical plasma is also only collected from male donors (to reduce TRALI risk) and at collection centre locations that enable freezing within the regulated timeframe. 

In recent years, there's been increasing use of emergency release of incompatible FFP (defined as group A to group B and AB patients) based on growing overseas evidence of relative safety in trauma settings. From 2016, The Australian & New Zealand Society of Blood Transfusion (ANZSBT) guidelines allowed use of A group plasma products (such as FFP) with low titre anti-B as an alternative to group AB in adults in emergencies or trauma, when the patient’s ABO group is unknown.

Existing international studies to support this practice have focused on massive transfusion (MT) in trauma settings with limited evidence in the more variable non-trauma MT group. Utilising data from the Australian and New Zealand Massive Transfusion Registry (ANZ-MTR), Loh and colleagues sought to assess the prevalence of ABO-incompatible FFP in MT recipients, as well as the characteristics and outcomes of trauma and non-trauma patients who received ABO-compatible or incompatible FFP. 

Transfusion-transmissible infection surveillance report for 2024

Jointly produced by Lifeblood and the Kirby Institute is the 2024 transfusion-transmissible infections in Australia surveillance report. 

This report summarises donation testing data, and incidence and prevalence trends for transfusion‑transmissible infections (TTIs) among Australian blood donors.

Lifeblood regularly reviews and updates the donor interview and selection process, taking into consideration local and overseas research studies, international best practice, literature reviews and analysis of surveillance data such as that included in this report.

Latest updates for warfarin reversal, cryoprecipitate and more

Health professionals can now access the latest updates for warfarin reversal (to support use of Beriplex®) and updates related to the transition to split apheresis cryoprecipitate and cryodepleted plasma components on the Lifeblood site.

Warfarin reversal

This page now reflects the updated recommendations produced by THANZ for warfarin reversal in the setting of four-factor prothrombin complex concentrate.

All dosing decisions should consider the individual patient, including: 

• their degree of bleeding 
• the ability to perform timely and adequate haemostatic interventions, and
• their underlying thrombotic risk that warranted anticoagulation with warfarin in the first place.

The updated 2024 THANZ recommendations for warfarin reversal in the setting of four-factor prothrombin complex concentrate advised that the management of non-bleeding patients on warfarin remain unchanged (from the 2013 update of consensus guidelines for warfarin reversal).

You'll find all the updated information on the transition to split apheresis cryoprecipitate, cryodepleted plasma components and cryoprecipitate dosing below. 

Building the transfusion community in 2025

The Transfusion practitioner forums for 2025 will start on Wednesday 5 February at 11.30am (AEDT). They'll continue right through the year on the first Wednesday of each month. 

Who should attend?

The forums are open to all health professionals and are designed to enhance our Transfusion practitioner microcredential modules. 

Even if you haven't explored the modules yet, feel free to come and engage with like-minded peers. 

What are we talking about in 2025?

Next month's forum will start with a discussion on the latest developments in the transfusion world in 2025. Based on these changes, we’ll explore what TPs might want to incorporate into their new year action plans. 

March will feature a discussion on education strategies for TPs covering some of the tricks of the trade.

And, in anticipation of the new microcredential module to be released, April will focus on adverse events and the role of the TP in managing and preventing them in their health service.

Upcoming opportunities