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May 23rd, 2003 Solvent-Detergent Plasma Could Save Money as Well as Lives A letter published this week in the prestigious Vox Sanguinis journal claims that the continued use of non virus inactivated fresh frozen plasma (FFP) in the UK probably kills 11 people per year. The authors state that this is likely to raise significant medico-legal issues, especially as alternative products such as solvent detergent (SD) plasma (Octaplas) are available. Responding to a recent review of the pharmacoeconomics of blood transfusion safety in which the cost-effectiveness of SD plasma had been questioned, Reidler et al assert that previous studies were significantly flawed, as they took no account of non-infectious complications. In a re-evaluation of the cost-effectiveness of SD plasma the authors have identified Transfusion Related Acute Lung Injury (TRALI) as the most clinically and economically important non-infectious complication of FFP treatment. TRALI is a severe, potentially fatal transfusion reaction caused by antibodies to the white cells of some blood donors. The syndrome is characterised by chills, fever, breathing difficulties and low blood pressure. TRALI is estimated to occur in one in every two to five thousand plasma transfusions, and is fatal in 5-14% of cases. Given that around 350,000 units of FFP are transfused in the UK each year, and assuming a mean incidence of 1:3,500 and a mortality of 10% - 11 patients will die as a result of this treatment. By contrast, there have been no reports of TRALI occurring after transfusion of Octaplas, the unique virus inactivated (SD) plasma manufactured and distributed by Octapharma. In view of the above, Reidler et al suggest that if all FFP in the UK was replaced by Octaplas, 11 deaths/year would be avoided. The cost of making this switch would be less than £10 million (€14 million) / year. However, as compensation and personal injury awards for transfusion related complications have typically been greater than £1 million (1.4 million) per person, it is clear that SD plasma could save money as well as lives, not only in the UK, but around the world. © Octapharma AG, 2003 |