Del Río Garma, Julio

García-Erce, José A.

Pereira, Arturo

English

RUNA -  Repositorio de Saúde

83Blood Transfus 2019; 17: 83  DOI 10.2450/2018.0056-18© SIMTIPRO SrlLetter to the EditorOn the cost-utility of methylene blue-photoinactivated plasma versus quarantine plasma in SpainArturo Pereira1, Julio del Río-Garma2, José A. García-Erce31Hospital Clínic, Barcelona; 2Ourense University Hospital Complex, Ourense; 3Navarra Blood and Tissue Bank, Pamplona, SpainDear Sir,In the report on the cost-utility of methylene blue-photoinactivated plasma (MBPIP) versus quarantine plasma (QP) in Spain, Babigumira et al.1 assume that MBPIP is more effective than QP. We would like to point out that such assumption is based on an incomplete evaluation of all the available data.Studies conducted in Spain and elsewhere have shown that MBPIP is actually less effective than QP in some of the main indications for plasma transfusion. In thrombotic thrombocytopenic purpura, the use of MBPIP as the replacement fluid for plasma exchange yielded worse clinical results than QP2. In a large university hospital in Spain, the introduction of MBPIP increased the demand for plasma and plasma derivatives, probably to compensate for the reduced haemostatic capacity of MBPIP3. In a model of massive transfusion in trauma patients, pathogen-inactivated blood products - including plasma - were linked to poorer outcomes and increased transfusion4. We conjecture that had the authors took into account these data, then QP would have dominated MBPIP in most scenarios. Moreover, inclusion of additional costs derived from the increased compensatory demand for plasma and plasma derivatives would have turned the cost equation against MBPIP in all scenarios. Lack of consideration of the above cited reports, even in sensitivity analyses, has unfairly biased the conclusion by Babigumira et al.1 against QP.The Author declare no conflicts of interest.References1) Babigumira JB, Lubinga SJ, Castro E, Custer B. Cost-utility and budget impact of methylene blue-treated plasma compared to quarantine plasma. Blood Transfus 2018; 16: 154-62.2) del Río-Garma J, Alvarez-Larrán A, Martínez C, et al. Methylene blue-photoinactivated plasma versus quarantine fresh frozen plasma in thrombotic thrombocytopenic purpura: a multicentric, prospective cohort study. Br J Haematol 2008; 143: 39-45.3) Atance R, Pereira A, Ramírez B. Transfusing methylene blue-photoinactivated plasma instead of FFP is associated with an increased demand for plasma and cryoprecipitate. Transfusion 2001; 41: 1548-52.4) Hess JR, Pagano MB, Barbeau JD, Johannson PI. Will pathogen reduction of blood components harm more people than it helps in developed countries? Transfusion 2016; 56: 1236-41.Arrived: 19 March 2018 - Accepted: 20 March 2018Correspondence: Arturo PereiraHospital ClínicVillarroel 17008036 Barcelona,  Spaine-mail: apereira@clinic.ub.es© SIMTIPRO S lAll rights reserved - For personal use only No other use without premission

On the cost-utility of methylene blue-photoinactivated plasma versus quarantine plasma in Spain

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On the cost-utility of methylene blue-photoinactivated plasma versus quarantine plasma in Spain

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