Decline in platelet microparticles contributes to reduced hemostatic potential of stored plasma

• Published in: Thrombosis research Vol. 128; no. 1; pp. 35 - 41
• Main Authors: Matijevic, Nena, Wang, Yao-Wei W, Kostousov, Vadim, Wade, Charles E, Vijayan, K. Vinod, Holcomb, John B
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 01.07.2011; Elsevier
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Blood and lymphatic vessels; Blood coagulation. Blood cells; Blood Platelets; Blood Preservation; Cardiology. Vascular system; CAT; Cell-Derived Microparticles; Cryopreservation; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Fresh-frozen plasma; Fundamental and applied biological sciences. Psychology; Hematology, Oncology and Palliative Medicine; Hemostasis; Humans; Medical sciences; Microparticles; Middle Aged; Molecular and cellular biology; Partial Thromboplastin Time; Plasma; Platelet; Platelets; Thrombelastography; Thromboelastography; Transfusion; Trauma; Young Adult; ETP; PS; Transfusion; Inter Quartile Range; Fresh Frozen Plasma; Endogenous Thrombin Potential; Microparticles; PRP; FFP; MFI; PPP; FITC; RBC; Median Fluorescence Intensity; Platelet Poor Plasma; Red Blood Cell; Platelet Factor 4; Tissue Factor; Microparticle; Phycoerythrin-Cyanin 5; Phosphatidylserine; Thromboelastography; MP; PC5; Platelet Rich Plasma; IQR; Thawed Plasma; Trauma; American Association of Blood Banks; TF; PE; CAT; Phycoerythrin; TEG; Fluoroscein Isothiocyanate; Calibrated Automated Thrombogram; Fresh-frozen plasma; TP; Platelets; AABB; PF4; Fissipedia; Carnivora; Hemostatic; Fresh frozen plasma; Conservation; Cardiovascular disease; Vertebrata; Platelet; Mammalia; Cat
• ISSN: 0049-3848; 1879-2472
• DOI: 10.1016/j.thromres.2011.02.011

Abstract Introduction In an effort to administer life-saving transfusions quickly, some trauma centers maintain thawed plasma (TP). According to AABB, TP is approved for transfusion for up to five days when stored at 1 - 6 °C. However, the alterations in microparticles (MP) contained in the plasma, which are an integral component of plasma's hemostatic capacity, are not well characterized. We report on MP changes in TP between its initial thaw (FFP-0) and five days (FFP-5) of storage. Materials and Methods FFP units (n = 30) were thawed at 37 °C and kept refrigerated for five days. Phenotypes of residual cells, which include platelets, erythrocytes, leukocytes, monocytes, endothelial cells, and MP counterparts of each cell type, were analyzed by flow cytometry. Functional assays were used for MP procoagulant activity, plasma thrombin generation, and clotting properties (thromboelastography). Results In FFP-0 the majority (94%) of residual cells were platelets, along with significant levels of platelet MPs (4408 × 103 /L). FFP-5 showed a decline in MP count by 50% (p < 0.0001), and procoagulant activity by 29% (p < 0.0001). FFP-5 exhibited only 54% (p < 0.0001) of the potential for thrombin generation as FFP-0, while thromboelastography indicated a slower clotting response (p < 0.0001) and a longer delay in reaching maximum clot (p < 0.01). Removal of MP by filtration resulted in reduced thrombin generation, while the MP replacement restored it. Conclusions Decline in MP with storage contributes to FFP-5's reduced ability to provide the hemostatic potential exhibited by FFP-0, suggesting the presence of platelet MPs in freshly TP may be beneficial and protective in the initial treatment of hemorrhage.