Plasma Transfusion Products and Contamination with Cellular and Associated Pro-Inflammatory Debris

Area of Science:

• Transfusion Medicine
• Immunology
• Hematology

Background:

• Stored plasma products are assumed to be acellular, eliminating the need for leukoreduction.
• This study investigated potential leukocyte and platelet contamination in donor plasma.
• The research aimed to determine if this contamination triggers pro-inflammatory responses after storage.

Purpose of the Study:

• To quantify leukocyte and platelet contamination in never-frozen liquid plasma from trauma centers.
• To assess if the level of cellular debris is sufficient to induce an innate immune response.
• To evaluate the inflammatory potential of stored plasma products.

Main Methods:

• Analyzed liquid plasma samples from two trauma centers for leukocyte and platelet contamination.
• Subjected known quantities of leukocytes to freeze-thaw cycles.
• Measured interleukin-6 (IL-6) induction in whole blood after adding cellular debris.

Main Results:

• Plasma units showed significant leukocyte and platelet contamination, exceeding levels found in previous studies.
• Specifically, Louisiana samples had 17.3 ± 4.5 million leukocytes and 0.86 ± 0.20 billion platelets per unit.
• Debris from as few as 1 million leukocytes significantly increased IL-6 levels (p < 0.0001).

Conclusions:

• Stored plasma from trauma banks is highly contaminated with leukocytes and platelets.
• Contamination levels are over 15-fold higher than needed to elicit inflammatory responses.
• New manufacturing and quality control are essential to remove unrecognized cellular contamination in plasma products.