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Effect of cold storage on the haemostatic cascade systems
S Omran1, M Hallouda, F Essawi
1Haematology Department, Theodor Bilharz Research Institute, Embaba, Giza, Egypt.
Transfusion Science
|August 5, 1996
Summary
Stored whole blood significantly impacts coagulation and fibrinolytic systems over time. Fresh frozen plasma minimally affects these systems, making it preferable for transfusion in certain patients.
Area of Science:
- Transfusion Medicine
- Hematology
- Biochemistry
Background:
- Citrate phosphate dextrose adenine (CPDA) whole blood and fresh frozen plasma (FFP) are common blood products.
- Understanding their effects on hemostasis and the kallikrein system is crucial for clinical practice.
Purpose of the Study:
- To evaluate the impact of stored CPDA whole blood and FFP on coagulation, fibrinolytic, and kallikrein systems.
- To compare the stability of these systems in whole blood versus FFP.
Main Methods:
- Assessed coagulation parameters, including Antithrombin III (ATIII) activity and thrombin-antithrombin complex levels.
- Measured fibrinolytic markers such as alpha 2-antiplasmin, plasminogen, and D-dimer.
- Evaluated the kallikrein system by measuring C1-inhibitor and kallikrein activity.
Main Results:
- Stored whole blood showed decreased ATIII, alpha 2-antiplasmin, and plasminogen, with increased D-dimer and kallikrein activity over 5 weeks.
- C1-inhibitor activity decreased significantly within the first week of whole blood storage.
- Fresh frozen plasma demonstrated minimal changes in all measured parameters after 12 months of storage.
Conclusions:
- Whole blood stored for over 3 weeks significantly activates coagulation, fibrinolytic, and kallikrein systems.
- Fresh frozen plasma is a more stable alternative, with minimal impact on these systems.
- FFP combined with packed red blood cells is recommended over prolonged-stored whole blood, particularly for patients with existing proteolytic enzyme system activation.