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Proverbio D, Perego R, Baggiani L, Spada E. Hemostatic Activity of Canine Never-Frozen Liquid Plasma Collected for Transfusion. Front Vet Sci 2022; 9:731617. [PMID: 35242834 PMCID: PMC8887598 DOI: 10.3389/fvets.2022.731617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 01/20/2022] [Indexed: 11/22/2022] Open
Abstract
This study measured the changes of hemostatic activity in liquid plasma (LP) over 7 days of storage. Five canine plasma units, divided into two aliquots were evaluated: one stored refrigerated at 2–6°C as never-frozen LP and one frozen at −18°C as fresh frozen plasma (FFP). Clotting times, coagulation activities of factor (F) V, VIII, X, XI, antithrombin (AT), and von Willebrand (vWF), fibrinogen and D-dimers (DD) content were assessed before storage (baseline value), and after 12, 24, 48 h and 7 days (D7) in LP stored refrigerated, and on day 7 in FFP. At baseline median values of all factor activity were greater than 80%, and for clotting times, AT, fibrinogen and DD content, were within the canine reference range. Some hemostatic parameters changed significantly over 7 days and at the end of storage in LP. However, median activities of FV, FVIII, FX and FXI, coagulation time, AT, fibrinogen and DD content remained within reference ranges at all time points. The only exception was for vWF which median activity was lower than reference range for all storage time points. Activity of FVIII was significant lower in LP at D7 when compared to activity in FFP, with values of 62 vs. 118%, respectively. DD content showed a median value higher than reference range in FFP at D7. Despite some statistically significant changes at the end of 7-day storage period, never-frozen LP maintained median factor activities >80% for most factors. The clinical impact of the drop over time of vWF activity is unknown.
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Fadeyi EA, Saha AK, Soltani S, Naal T, Palmer R, Bakht A, Warren CS, Simmons JH, Pomper GJ. A comparison between liquid group A plasma and thawed group A plasma for massive transfusion activation in trauma patients. Vox Sang 2021; 117:513-519. [PMID: 34725834 DOI: 10.1111/vox.13210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 09/24/2021] [Accepted: 09/24/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES The use of group A thawed 24-h plasma when resuscitating haemorrhagic shock patients has become more common; however, limited data exist on the clinical use of liquid plasma (LP). Our aim is to determine whether LP is of clinical benefit to patients requiring massive transfusion. MATERIALS AND METHODS The objective of this retrospective study was to detect any difference in 24-h survival between patients receiving liquid or thawed plasma (TP) during their massive transfusion activation. Other objectives were to report any difference in hospital length of stay (LOS), intensive care unit (ICU) LOS and in-hospital survival. Data collected included gender, age, mechanism of injury, Injury Severity Score, Revised Trauma Score and Trauma Injury Severity Score. RESULTS A total of 178 patients received 1283 units of LP, median 4 and range (1-56), whereas 270 patients received 2031 units of TP, median 5 and range (1-87). The two study groups were comparable in terms of gender, age, mechanism of injury, whole blood, red blood cells, platelets and cryoprecipitate transfused. The use of LP during the massive transfusion activation in traumatically injured patients was not associated with increased 24-h survival compared to when using TP, p = 0.553. CONCLUSION Our study did not show a difference in 24-h or 30-day survival between the use of LP compared to TP in trauma patients. LP should be considered an alternative to TP in trauma patients requiring immediate plasma resuscitation.
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Affiliation(s)
- Emmanuel A Fadeyi
- Department of Pathology and Laboratory Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.,Department of Pathology and Laboratory Medicine, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Amit K Saha
- Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Sohaila Soltani
- Department of Pathology and Laboratory Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.,Department of Pathology and Laboratory Medicine, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Tawfeq Naal
- Department of Pathology and Laboratory Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.,Department of Pathology and Laboratory Medicine, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Robert Palmer
- Department of Pathology and Laboratory Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.,Department of Pathology and Laboratory Medicine, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Azad Bakht
- Department of Pathology and Laboratory Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.,Department of Pathology and Laboratory Medicine, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Christina S Warren
- Department of Pathology and Laboratory Medicine, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Julie H Simmons
- Department of Pathology and Laboratory Medicine, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Gregory J Pomper
- Department of Pathology and Laboratory Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.,Department of Pathology and Laboratory Medicine, Wake Forest Baptist Health, Winston-Salem, NC, USA
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Rapaille A, Lotens A, de Valensart N, Najdovski T, Green L. Evaluation of the hemostatic capacity of methylene blue-treated liquid (not frozen) plasma stored up 14 days at 2° to 6°C. Transfusion 2021; 61:2450-2457. [PMID: 33913163 DOI: 10.1111/trf.16427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 03/22/2021] [Accepted: 04/16/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Early plasma transfusion for management of bleeding, particularly trauma, is associated with better outcomes. Improving the availability/safety of plasma transfusion for patients is essential for transfusion services. The aim of this study is to evaluate the hemostatic capacity of methylene-blue (MB) liquid (not frozen) plasma over time. MATERIALS AND METHODS Twenty whole blood-derived plasma units collected from male donors were separated and processed within 18 h of collection. Individual plasmas were treated with MB and stored in liquid status at 2-6°C for 14 days. A range of coagulation assays, including thrombin generation, rotational thromboelastometry (ROTEM), and Thrombodynamics were tested at different time-points, together with bacterial growth. RESULTS Apart from Factor (F)XII, other coagulation factors (fibrinogen, FV, FVIII, FXI) reduced significantly after MB treatment, with levels remaining stable except for FVIII afterward. By day 14, most clotting factors were >0.7 IU/ml, apart from FVIII. There was a disproportionate decrease in Protein S (PS) activity compared to free PS antigen and by day 14 its value was ~50%. There was no significant difference in maximum clot formation (ROTEM) and clot-density (Thrombodynamics) over time. Endogenous thrombin potential (Thrombin-Generation), clot-size, and velocity index (Thrombodynamics) decreased significantly over time consistent with clotting factor reduction. There was no bacterial growth. CONCLUSIONS MB-treated liquid plasma stored at 2-6°C can be used for up to 14 days: the long shelf-life, the liquid status, and the MB treatment will improve its availability for management of bleeding as well as providing a safe component from pathogens.
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Affiliation(s)
| | - Anaïs Lotens
- Service du Sang, Belgian Red Cross, Suarlée, Belgium
| | | | | | - Laura Green
- NHS Blood and Transplant and Barts Health NHS Trust, Queen Mary University of London, London, UK
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Stegmayr B, Newman E, Witt V, Derfler K, Leitner G, Eloot S, Dhondt A, Deeren D, Ptak J, Blaha M, Lanska M, Gasova Z, Bhuiyan-Ludvikova Z, Hrdlickova R, Ramlow W, Prophet H, Kielstein JT, Liumbruno G, Mori E, Griskevicius A, Audzijoniene J, Vrielink H, Rombout-Sestrienkova E, Aandahl A, Sikole A, Tomaz J, Lalic K, Bojanic I, Strineholm V, Brink B, Berlin G, Dykes J, Nilsson T, Eich T, Hadimeri H, Welander G, Ortega Sanchez S, Ilhan O, Poole C. Using the World Apheresis Association Registry Helps to Improve the Treatment Quality of Therapeutic Apheresis. Transfus Med Hemother 2021; 48:234-239. [PMID: 34539317 DOI: 10.1159/000513123] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 04/07/2020] [Indexed: 01/20/2023] Open
Abstract
Therapeutic apheresis (TA) is prescribed to patients that suffer from a severe progressive disease that is not sufficiently treated by conventional medications. A way to gain more knowledge about this treatment is usually by the local analysis of data. However, the use of large quality assessment registries enables analyses of even rare findings. Here, we report some of the recent data from the World Apheresis Association (WAA) registry. Data from >104,000 procedures were documented, and TA was performed on >15,000 patients. The main indication for TA was the collection of autologous stem cells (45% of patients) as part of therapy for therapy. Collection of stem cells from donors for allogeneic transplantation was performed in 11% of patients. Patients with indications such as neurological diseases underwent plasma exchange (28%). Extracorporeal photochemotherapy, lipid apheresis, and antibody removal were other indications. Side effects recorded in the registry have decreased significantly over the years, with approximately only 10/10,000 procedures being interrupted for medical reasons. Conclusion Collection of data from TA procedures within a multinational and multicenter concept facilitates the improvement of treatment by enabling the analysis of and feedback on indications, procedures, effects, and side effects.
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Affiliation(s)
- Bernd Stegmayr
- Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Elizabeth Newman
- Bone Marrow Transplant and Apheresis, Concord, New South Wales, Australia
| | - Volker Witt
- St. Anna, Pediatric Department, Vienna, Austria
| | | | - Gerda Leitner
- Apheresis Unit, Haematological, AKH, Vienna, Austria
| | - Sunny Eloot
- Department of Nephrology, University Hospital, Ghent, Belgium
| | | | - Dries Deeren
- Department of Hematology, AZ Delta, Roeselare, Belgium
| | - Jan Ptak
- Transfusion Medicine, Frydek-Mistek, Czechia
| | - Milan Blaha
- Hemapheretic Center of the 3rd Department of Medicine, Medical Faculty and University Hospital, Hradec Kralove, Czechia
| | - Mirka Lanska
- Hemapheretic Center of the 3rd Department of Medicine, Medical Faculty and University Hospital, Hradec Kralove, Czechia
| | - Zdenka Gasova
- Institute of Hematology and Blood Transfusion, Prague, Czechia
| | | | | | | | | | - Jan T Kielstein
- Nephrology, Rheumatology, Blood Purification, Academic Teaching Hospital, Braunschweig, Germany
| | | | | | | | | | | | | | - Astrid Aandahl
- Center for Immunology and Transfusion, Akers University Hospital, Loerenskog, Norway
| | - Aleksandar Sikole
- Department of Nephrology, University Hospital, Skopje, North Macedonia
| | - Jorge Tomaz
- Apheresis Unit, Coimbra University Hospital, Coimbra, Portugal
| | - Katarina Lalic
- Institute for Endocrinology, University Hospital, Belgrade, Serbia
| | - Ines Bojanic
- Transfusion Medicine and Transplantation Biology, University, Zagreb, Croatia
| | | | - Bo Brink
- Department of Nephrology, University Hospital, Huddinge, Sweden
| | - Gösta Berlin
- Clinical Immunology and Transfusion Medicine, Linköping University, Linköping, Sweden
| | | | - Thomas Nilsson
- Department of Nephrology, University Hospital, Uppsala, Sweden
| | - Torsten Eich
- Blood Center, University, Uppsala, Sweden, Uppsala, Sweden
| | - Henrik Hadimeri
- Department of Nephrology, Skaraborg Hospital, Skövde, Sweden
| | | | | | - Osman Ilhan
- Department Haematology, University Hospital, Ankara, Turkey
| | - Colwyn Poole
- South African National Blood Service, Johannesburg, South Africa
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Hervig TA, Doughty HA, Cardigan RA, Apelseth TO, Hess JR, Noorman F, Bohoněk M, Yazer MH, Lu J, Wendel S, Sparrow RL. Re-introducing whole blood for transfusion: considerations for blood providers. Vox Sang 2020; 116:167-174. [PMID: 32996604 DOI: 10.1111/vox.12998] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 08/11/2020] [Indexed: 12/31/2022]
Abstract
Whole blood is the original blood preparation but disappeared from the blood bank inventories in the 1980s following the advent of component therapy. In the early 2000s, both military and civilian practice called for changes in the transfusion support for massive haemorrhage. The 'clear fluid' policy was abandoned and replaced by early balanced transfusion of platelets, plasma and red cells. Whole blood is an attractive alternative to multi-component therapy, which offers reduced hemodilution, lower donor exposure and simplified logistics. However, the potential for wider re-introduction of whole blood requires re-evaluation of haemolysins, storage conditions and shelf-life, the need for leucocyte depletion/ pathogen reduction and inventory management for blood providers. This review addresses these questions and calls for research to define the optimal whole blood product and the indications for its use.
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Affiliation(s)
- Tor A Hervig
- Blood Bank, Haugesund hospital, Haugesund, Norway
| | | | | | - Torunn O Apelseth
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - John R Hess
- Laboratory Medicine, University of Washington, Seattle, WA, USA
| | - Femke Noorman
- Quality, Research and Development, Military Blood Bank, Leiden, Netherlands
| | - Miloš Bohoněk
- Hematology, Biochemistry and Blood Transfusion, Central Military Hospital Prague, Prague, Czech Republic
| | - Mark H Yazer
- Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jia Lu
- Defence Medical & Environmental Research Institute, DSO National Laboratories (Kent Ridge), Singapore City, Singapore
| | | | - Rosemary L Sparrow
- Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic, Australia
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Is Fresh Frozen Plasma Still Necessary for Management of Acute Traumatic Coagulopathy? CURRENT ANESTHESIOLOGY REPORTS 2020. [DOI: 10.1007/s40140-020-00397-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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7
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Backholer L, Green L, Huish S, Platton S, Wiltshire M, Doughty H, Curnow E, Cardigan R. A paired comparison of thawed and liquid plasma. Transfusion 2016; 57:881-889. [DOI: 10.1111/trf.13915] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 09/21/2016] [Accepted: 09/21/2016] [Indexed: 01/01/2023]
Affiliation(s)
| | - Laura Green
- NHS Blood and Transplant
- Barts Health NHS Trust UK
- Blizzard Institute; Queen Mary University of London; London UK
| | | | | | | | | | | | - Rebecca Cardigan
- NHS Blood and Transplant; Cambridge UK
- Department of Haematology; University of Cambridge; Cambridge UK
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8
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Mörtzell Henriksson M, Newman E, Witt V, Derfler K, Leitner G, Eloot S, Dhondt A, Deeren D, Rock G, Ptak J, Blaha M, Lanska M, Gasova Z, Hrdlickova R, Ramlow W, Prophet H, Liumbruno G, Mori E, Griskevicius A, Audzijoniene J, Vrielink H, Rombout S, Aandahl A, Sikole A, Tomaz J, Lalic K, Mazic S, Strineholm V, Brink B, Berlin G, Dykes J, Toss F, Axelsson CG, Stegmayr B, Nilsson T, Norda R, Knutson F, Ramsauer B, Wahlström A. Adverse events in apheresis: An update of the WAA registry data. Transfus Apher Sci 2016; 54:2-15. [PMID: 26776481 DOI: 10.1016/j.transci.2016.01.003] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Apheresis with different procedures and devices are used for a variety of indications that may have different adverse events (AEs). The aim of this study was to clarify the extent and possible reasons of various side effects based on data from a multinational registry. The WAA-apheresis registry data focus on adverse events in a total of 50846 procedures in 7142 patients (42% women). AEs were graded as mild, moderate (need for medication), severe (interruption due to the AE) or death (due to AE). More AEs occurred during the first procedures versus subsequent (8.4 and 5.5%, respectively). AEs were mild in 2.4% (due to access 54%, device 7%, hypotension 15%, tingling 8%), moderate in 3% (tingling 58%, urticaria 15%, hypotension 10%, nausea 3%), and severe in 0.4% of procedures (syncope/hypotension 32%, urticaria 17%, chills/fever 8%, arrhythmia/asystole 4.5%, nausea/vomiting 4%). Hypotension was most common if albumin was used as the replacement fluid, and urticaria when plasma was used. Arrhythmia occurred to similar extents when using plasma or albumin as replacement. In 64% of procedures with bronchospasm, plasma was part of the replacement fluid used. Severe AEs are rare. Although most reactions are mild and moderate, several side effects may be critical for the patient. We present side effects in relation to the procedures and suggest that safety is increased by regular vital sign measurements, cardiac monitoring and by having emergency equipment nearby.
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Affiliation(s)
| | - E Newman
- Bone Marrow Transplant & Apheresis, New South Wales, Australia
| | - V Witt
- St. Anna, Vienna, Austria
| | | | | | | | | | | | | | - J Ptak
- Frydek-Mistek, Czech Republic
| | - M Blaha
- Hradec Kralove, Czech Republic
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9
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Cardigan R, Green L. Thawed and liquid plasma--what do we know? Vox Sang 2015; 109:1-10. [PMID: 25833464 DOI: 10.1111/vox.12251] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 12/16/2014] [Accepted: 12/16/2014] [Indexed: 12/21/2022]
Abstract
There is increasing interest in the use of liquid or frozen plasma thawed and stored for extended periods (>24 h) to reduce wastage and to improve rapid availability of plasma in massive transfusion protocols advocating the early use of plasma in trauma by some centres. There is now a body of studies that have assessed individual coagulation factors during storage of thawed plasma. These show that factor VIII (FVIII) is the worst affected factor and that its activity is mainly lost during the first 24 h following thawing. However, for most factors studied, there is a continual decline during further storage. The few studies that have assessed thrombin generation in thawed plasma have shown variable results. Extended storage of plasma is associated with an increase in levels of DEHP in the component and could theoretically increase the risk of bacterial contamination, although the latter does not appear to have been an issue in countries that have adopted the use of thawed plasma. There are no clinical studies relating to the efficacy of extended-thawed plasma, and therefore, the potential reduction in its efficacy must be balanced with the clinical need for the component.
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Affiliation(s)
| | - L Green
- NHS Blood & Transplant, and Barts Health NHS Trust and Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Bentzer P, Thomas OD, Westborg J, Johansson PI, Schött U. The volume-expanding effects of autologous liquid stored plasma following hemorrhage. Scandinavian Journal of Clinical and Laboratory Investigation 2013; 72:490-4. [PMID: 22974297 DOI: 10.3109/00365513.2012.699099] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Plasma use has increased since studies have suggested that early treatment with blood components in trauma with severe hemorrhage may improve outcome. Plasma is also commonly used to correct coagulation disturbances in non-bleeding patients. Little is known about the effects of plasma transfusion on plasma volume. We report a prospective interventional study in which the plasma volume-expanding effect of autologous plasma was investigated after a controlled hemorrhage. METHODS Plasma obtained by plasmapheresis from nine healthy regular blood donors was stored at 2-6°C. Five weeks after donation the subjects were bled of 600 ml and then transfused with 600 ml of autologous plasma. Plasma volume was estimated using (125)I-albumin before and after bleeding, and immediately after plasma transfusion. Plasma volume changes were then estimated by measuring changes in hematocrit during the following 3-h period. RESULTS Estimated plasma volume after bleeding was 3170 ± 320 ml and 3690 ± 380 ml (mean ± standard deviation) immediately following the transfusion of plasma (p 0.05). This increase in plasma volume corresponds to 86 ± 13% of the infused volume. Three hours after transfusion, plasma volume was still 3680 ± 410 ml. CONCLUSIONS Stored liquid plasma has a plasma volume expanding effect up to 86% of its infused volume with a duration of at least 3 h.
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Affiliation(s)
- Peter Bentzer
- Department of Anesthesia and Intensive Care, Skåne University Hospital and Lund University, Lund, Sweden
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11
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Better hemostatic profiles of never-frozen liquid plasma compared with thawed fresh frozen plasma. J Trauma Acute Care Surg 2013; 74:84-90; discussion 90-1. [PMID: 23271081 DOI: 10.1097/ta.0b013e3182788e32] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Immediate use of thawed fresh frozen plasma (FFP) when resuscitating hemorrhagic shock patients has become more common. According to the AABB (formerly known as American Association of Blood Banks), FFP is the preferred product that can be used up to 5 days after thawing. However, limited data exist on the clinical use and hemostatic profiles of Food and Drug Administration-approved liquid plasma (LQP), which can be stored at 1 °C to 6 °C for up to 26 days. We characterized changes in LQP hemostatic potential during 26 days of cold storage. METHODS Ten FFP and 10 LQP single-donor units, matched by sex and blood group, were analyzed. FFP was thawed and kept refrigerated for 5 days and LQP for 26 days. Plasma samples were evaluated at Days 0 and 5 for thawed plasma (TP) and 0, 5, 10, 20, and 26 for LQP, by thrombelastography, thrombogram, platelet counts, platelet microparticles, clotting factors, and natural coagulation inhibitors. RESULTS LQP had a better capacity to form a clot and generate thrombin compared with TP. LQP's hemostatic potential, expressed as endogenous thrombin potential (total amount of thrombin [nM] formed over time [minute]), initially exceeded that of TP (1,425 vs. 1,184, p < 0.05) but decreased to levels similar to TP by Day 26 (1,201 vs. 1,103, p = 0.15). Significantly higher platelet microparticles were found in LQP on Day 26 compared with those in LQP on Day 0 (23.6 x 10(9)/L vs. 3 x 10(9)/L, p < 0.001) or those in TP on Day 5 (2.8 x 10(9)/L). By Day 26, the majority of clotting factors and inhibitors retained more than 88% of their initial activities in LQP, with the few exceptions of factors well known to be unstable. CONCLUSION The hemostatic profiles of LQP were better and sustained five times longer than the more commonly used TP, indicating that never-frozen plasma can be considered for use in the United States in trauma patients requiring immediate plasma resuscitation.
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12
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Thiele T, Kellner S, Hron G, Wasner C, Nauck M, Zimmermann K, Wessel A, Warkentin TE, Greinacher A, Selleng K. Storage of thawed plasma for a liquid plasma bank: impact of temperature and methylene blue pathogen inactivation. Transfusion 2012; 52:529-36. [PMID: 21880044 DOI: 10.1111/j.1537-2995.2011.03317.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Rapid transfusion of fresh-frozen plasma (FFP) is desired for treating coagulopathies, but thawing and issuing of FFP takes more than 40 minutes. Liquid storage of plasma is a potential solution but uncertainties exist regarding clotting factor stability. We assessed different storage conditions of thawed FFP and plasma treated by methylene blue plus light (MB/light) for pathogen inactivation. STUDY DESIGN AND METHODS Fifty thawed apheresis plasma samples (approx. 750 mL) were divided into three subunits and either stored for 7 days at 4°C, at room temperature (RT), and at 4°C after MB/light treatment. Clotting factor activities (Factor [F] II, FV, FVII through FXIII, fibrinogen, antithrombin, von Willebrand factor antigen, Protein C and S) were assessed after thawing and on Days 3, 5, and 7. Changes were classified as "minor" (activities within the reference range) and "major" (activities outside the reference range). RESULTS FFP storage at 4°C revealed major changes for FVIII (median [range], 56% [33%-114%]) and Protein S (51% [20%-88%]). Changes were more pronounced when plasma was stored at RT (FVIII, 59% [37%-123%]; FVII, 69% [42%-125%]; Protein S, 20% [10%-35%]). MB/light treatment of thawed FFP resulted in minor changes. However, further storage for 7 days at 4°C revealed major decreases for FVIII (47% [12%-91%]) and Protein S (49% [18%-95%]) and increases for FVII (150% [48%-285%]) and FX (126% [62%-206%]). CONCLUSION Storage of liquid plasma at 4°C for 7 days is feasible for FFP as is MB/light treatment of thawed plasma. In contrast, storage of thawed plasma for 7 days at RT or after MB/light treatment at 4°C affects clotting factor stability substantially and is not recommended.
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Affiliation(s)
- Thomas Thiele
- Institut für Immunologie und Transfusionsmedizin, Ernst-Moritz-Arndt Universität, Greifswald, Germany
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13
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Ettinger A, Miklauz MM, Hendrix BK, Bihm DJ, Maldonado-Codina G, Goodrich RP. Quality of proteins in riboflavin and UV light-treated FFP during 1year of storage at −18°C. Transfus Apher Sci 2012; 46:15-8. [DOI: 10.1016/j.transci.2011.10.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Revised: 08/11/2011] [Accepted: 10/13/2011] [Indexed: 10/15/2022]
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14
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Sheffield WP, Bhakta V, Mastronardi C, Ramirez-Arcos S, Howe D, Jenkins C. Changes in coagulation factor activity and content of di(2-ethylhexyl)phthalate in frozen plasma units during refrigerated storage for up to five days after thawing. Transfusion 2011; 52:493-502. [DOI: 10.1111/j.1537-2995.2011.03300.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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15
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Norda R, Schött U, Berséus O, Åkerblom O, Nilsson B, Ekdahl KN, Stegmayr BG, Knutson EF. Complement activation products in liquid stored plasma and C3a kinetics after transfusion of autologous plasma. Vox Sang 2011; 102:125-33. [DOI: 10.1111/j.1423-0410.2011.01522.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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16
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Tynell E, Andersson TM, Norda R, Edgren G, Nyren O, Shanwell A, Reilly M. Should plasma from female donors be avoided? A population-based cohort study of plasma recipients in Sweden from 1990 through 2002. Transfusion 2010; 50:1249-56. [DOI: 10.1111/j.1537-2995.2009.02568.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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17
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von Heymann C, Keller MK, Spies C, Schuster M, Meinck K, Sander M, Wernecke KD, Kiesewetter H, Pruss A. Activity of clotting factors in fresh-frozen plasma during storage at 4°C over 6 days. Transfusion 2009; 49:913-20. [DOI: 10.1111/j.1537-2995.2008.02063.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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18
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Use of plasma: Clinical indications and types of plasma components in Sweden. Transfus Clin Biol 2007; 14:560-3. [DOI: 10.1016/j.tracli.2008.02.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2008] [Accepted: 02/28/2008] [Indexed: 11/23/2022]
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