Coagulation profile of liquid-state plasma

• Published in: Transfusion (Philadelphia, Pa.) Vol. 53; no. 3; pp. 579 - 590
• Main Authors: Gosselin, Robert C., Marshall, Carol, Dwyre, Denis M., Gresens, Chris, Davis, Diana, Scherer, Lynette, Taylor, Douglas
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.03.2013; Wiley; Wiley Subscription Services, Inc
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Coagulation - physiology; Blood Coagulation Factors - analysis; Blood Coagulation Factors - metabolism; Blood Coagulation Tests; Blood Preservation - methods; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Fibrinolytic Agents - analysis; Hemostasis - physiology; Humans; Male; Medical sciences; Partial Thromboplastin Time; Plasma - chemistry; Plasma - physiology; Proteolysis; Prothrombin Time - methods; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Blood coagulation; Liquid; Transfusion; Blood plasma
• ISSN: 0041-1132; 1537-2995
• DOI: 10.1111/j.1537-2995.2012.03772.x

BACKGROUND: Use of liquid plasma (LP) has been reported as early as the mid 1930s. Unlike fresh‐frozen plasma (FFP), LP is maintained at 1 to 6°C for up to 40 days after collection and processing. Despite its approved use by the US Food and Drug Administration, the coagulation profile of LP is incompletely described. In this study we evaluate the coagulation profile of LP stored up to 30 days. STUDY DESIGN AND METHODS: LP was prepared by removing plasma from nonleukoreduced whole blood within 24 hours of collection. Three LP units from each ABO group were collected and stored at 1 to 6°C. Plasma aliquots were obtained at Postcollection Days 1 to 5, 10, 15, 20, 25, and 30 and then stored at −70°C. Each aliquot was tested for prothrombin time, activated partial thromboplastin time, and other coagulation and fibrinolytic factors. RESULTS: There was a significant decrease in Factor (F)V, FVII, FVIII, von Willebrand factor (VWF), protein S (PS) activity, and endogenous thrombin potential on Day 15 compared with Day 1. No significant difference was observed for PS antigen, D‐dimer, or thrombin‐antithrombin complex. At least 50% activity of all measured factors was noted on Day 15, compared to Day 1. Considerable heterogeneity was observed between the different blood groups for FVII, FVIII, and VWF. CONCLUSION: These data demonstrate that LP maintains at least 50% of factor activity and thrombin‐generating capacity up to 15 days of refrigerated storage. It may be more appropriate to limit LP storage and supplement with FFP when used for management of massively bleeding patients.