Recording intelligenceAI-generated brief · check the source for context

036: Group A Plasma in Trauma with Nancy Dunbar & Tait Stevens

55:07 recording · EN · 3 speakers

Watch the original

Brief overview

Two multicenter studies find group A plasma in trauma shows no increased mortality for incompatible patients.

  1. AB plasma supply cannot meet trauma demandOnly about 4% of the world is group AB, yet some trauma centers want a 20% AB supply.
  2. No mortality signal in incompatible recipientsBoth papers found group B and AB patients given group A plasma died no more often than expected.
  3. Group A plasma is a bridge, not foreverChaffin insists an ABO type must be drawn so the patient moves to identical plasma; Dartmouth caps it at four units.
Executive Summary AI
  • Host Joe Chaffin frames the problem: massive trauma transfusion now uses far more plasma, but only about 4% of people are group AB, so the traditional universal AB plasma cannot keep up.
  • Tate Stevens and Nancy Dunbar explain that five-day thawed plasma makes early resuscitation possible, and that maintaining a thawed AB inventory at a rural trauma center wastes scarce AB units, which pushed Dartmouth to switch to group A plasma in 2012.
  • Dunbar's STAT study recruited 17 centers (16 US, one UK), excluded group O recipients, and compared 354 incompatible group B and AB patients with 809 group A patients against their TRISS-predicted mortality.
  • Her results showed no observable difference in overall mortality, 24-hour mortality or hospital length of stay, and no transfusion reactions at all reported in the incompatible group, though incompatible patients had more penetrating injury.
  • Stevens' EAST multicenter study covered roughly 1,500 massive transfusion protocol patients, of whom 120 (about 8%) received incompatible type A plasma, and found no difference in morbidity, length of stay or transfusion reactions apart from the incompatible group receiving more plasma.
Key Quote
“Our results were that there was basically no difference.”
— Tate Stevens
Key Quote
“All we've been able to show, which is something, is that it doesn't appear to increase the risk of mortality.”
— Nancy Dunbar
Key Quote
“this is just yet another piece of evidence to help me sleep better at night and know that I might not be harming people in my efforts to help them.”
— Nancy Dunbar