ABO不同型血浆输注的风险认知与临床实践进展

Risks of ABO Non-identical Plasma:Cognitive and Clinical Practice

血浆输注可补充各类凝血因子、纠正凝血功能障碍,在大出血患者的救治中发挥着重要作用。通用型血浆和低效价O型全血能够提高大出血患者紧急输血的时效性和血液成分的可及性,ABO不同型血浆输注策略逐渐在国外临床实践中得到推广和应用。ABO不同型血浆输注分为主动输注和被动输注,主动输注的血浆主要包括AB型血浆和A型血浆;被动输注是以低效价O型全血和不同型单采血小板的形式输注不同型血浆,这些ABO不同型血浆输注会存在一定程度的溶血风险和循环免疫复合物风险。因此,理解ABO不同型血浆输注产生的风险,权衡急救输血过程中ABO不同型血浆输注策略带来的收益,是一个值得关注并深入探讨的问题。

Plasma transfusion is clinically used to replenish clotting factors and correct coagulopathy,playing an important role in the treatment of massive hemorrhage.Universal plasma and low titer group O whole blood can improve the timeliness and accessibility of urgent transfusions in patients with major bleeding.The strategy of ABO non-identical plasma transfusion,in the form of active and passive transfusion,has been extensively adopted in clinical practice.Active transfusion mainly includes group AB and A plasma;passive transfusion,on the other hand,involves the transfusion of low titer group O whole blood and ABO non-identical platelets.However,hemolysis and circulating immune complex formation are recognized to be the risks associated with transfusion of ABO non-identical plasma.Together,the risk-benefit trade-off with transfusion of non-ABO identical plasma deserves more attention and further exploration.