The fresh frozen plasma (FFP) is frequently prescribed either for therapeutic or prophylactic transfusion. The international normalised ratio (INR) value of 1.50 and above is frequently reported to be a transfusion trigger for FFP prior to interventional procedure. This study aimed to evaluate the efficacy of prophylactic FFP transfusion in normalising the INR and to determine the post-transfusion outcomes. Methods: A prospective cross-sectional study involved 81 patients who received prophylactic FFP transfusion over a period of three months. All demographic, clinical data and outcomes of FFP transfusion were captured and filled in the research proforma. Results: The proportion of patients achieved posttransfusion INR below 1.51 was 30.30% (n=27). The majority of patients underwent the interventional procedures with posttransfusion INR > 1.50 (n=52) without experiencing any bleeding episodes. Overall, FFP transfusion resulted in significant median INR difference from 1.89 (IQR, 0.53) to 1.60 (IQR, 0.25); p< 0.001. The greater median INR difference was observed in group with pretransfusion INR > 2.00 and who received FFP doses between 10.00 to 20.00 ml kg-1 (p < 0.001). The INR difference showed the significant, positive correlation with pretransfusion INR values (rs= 0.83, p < 0.001) and FFP doses (rs= 0.72, p< 0.001). Conclusions: The interventional procedures were safely carried out despite abnormal posttransfusion INR. The prophylactic FFP transfusions could be avoided in patients with mild coagulopathy (INR 1.50 - 2.00) prior interventional procedures.
Haemolytic Disease of Foetus and Newborn (HDFN) and Haemolytic Transfusion Reaction (HTR) may occur due to antibodies against Kidd antigen. In Malaysia, the prevalence of RBC alloimmunization due to Kidd antibody for cases of HDFN and HTR have been reported [1-2] however there is insufficient data in Hospital Umum Sarawak (HUS).The aim of this study is to determine whether Kidd alloimmunization causes HDFN and HTR. Indirectly categorize Kidd phenotype blood in regular blood donors.
Kidd blood group system is distributed differently within populations. In Malaysia, the prevalence of Kidd phenotypes have been reported but not in Hospital Umum Sarawak (HUS).We characterised Kidd phenotypes among regular blood donors in HUS. Methods: A cross-sectional study was done from 1st September 2015 to 10th September 2015. Blood samples were collected from 250 regular blood donors of different ethnicities in HUS. Samples were then investigated for Kidd blood group phenotypes by utilising Seraclon anti-Jka and anti-Jkb reagents employing the Diamed-ID gel card system. Results: Phenotype Jk(a+b+) was found in 110 out of 250 (44.0%) and phenotype Jk (a-b-) phenotype in seven out of 250 (2.8%) blood donors. Jk(a+b-) was detected in 60 out of 250 (24.0%) and Jk(a-b+) in 73 out of 250 (29.2%) donors. Kidd phenotype was detected in four ethnics; Chinese 50.8%, Malays 38.4%, Bidayuh 10.0% and Iban 0.8%. Jk(a-b-) phenotype was present only in the Malays; seven out of 250 (2.8%) but not found in other ethnicities. Conclusion: Jk(a+b+) is the most common Kidd phenotype found in regular blood donors in HUS in the four ethnicities studied. Only Malays exhibit the Jk(a-b-) phenotype which is a rare phenotype. The results of this study may serve as a preliminary database for Kidd blood group profile of regular blood donors in HUS.