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Thawed and liquid plasma--what do we know?
1NHS Blood & Transplant, Cambridge, UK.
Vox Sanguinis
|April 3, 2015
Summary
Extended storage of thawed plasma may reduce wastage but impacts coagulation factor levels. Further research is needed to balance potential efficacy reduction with clinical needs in massive transfusion protocols.
Area of Science:
- Transfusion Medicine
- Hematology
Background:
- Increasing interest in extended storage of thawed plasma to minimize wastage and enhance availability for massive transfusion protocols.
- Existing studies assess coagulation factor stability in thawed plasma, with Factor VIII (FVIII) being the most affected.
Purpose of the Study:
- To evaluate the impact of extended storage on the quality and efficacy of thawed plasma.
- To synthesize current knowledge on coagulation factor activity, thrombin generation, and potential risks associated with extended-thawed plasma storage.
Main Methods:
- Review of existing studies assessing coagulation factor activity and thrombin generation in thawed plasma.
- Analysis of data on DEHP levels and bacterial contamination risks in extended-stored plasma.
Main Results:
- Factor VIII (FVIII) shows significant activity loss within 24 hours of thawing, with continued decline for most factors during extended storage.
- Thrombin generation studies yield variable results.
- Extended storage is linked to increased DEHP levels; bacterial contamination has not been a significant issue in practice.
Conclusions:
- Extended storage of thawed plasma presents a trade-off between reduced wastage and potential decreased efficacy due to coagulation factor degradation.
- Clinical studies on the efficacy of extended-thawed plasma are lacking, necessitating a careful balance between component availability and patient outcomes.
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