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Published on: March 20, 2021
Quality Assessment and Clinical Utility of Plasma Obtained Via Apheresis vs That Obtained from Whole Blood
Eiman Hussein1, Azza Aboul Enein1
1Department of Clinical and Chemical Pathology, Division of Transfusion Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt.
Objective:
We studied the impact of storage of thawed plasma (TP) on the in vitro coagulation quality and posttransfusion outcomes of apheresis plasma (AP) vs whole blood plasma (WBP).
Methods:
One hundred units of each product were analyzed. In vitro assays were performed on TP on day 0, day 2, and after refreezing, evaluating international normalized ratio (INR), activated partial thromboplastin time (aPTT), fibrinogen, and factors V and VIII. Transfusion of TP on day 2 was studied in 70 patients with liver cirrhosis and 25 patients with thrombotic thrombocytopenic purpura (TTP).
Results:
Refrozen specimens from both products showed a significant decline of all values, although AP had a considerably greater coagulation profile (P < .05).On day 0 and day 2, we observed significant decreases in coagulation values (except fibrinogen) with WBP, compared with AP (P < .05). The WBP, however, provided similar INR for patients with liver cirrhosis and TTP, as compared with AP. The AP resulted in a significant correction of aPTT following plasma exchange in TTP (P < .05).
Conclusion:
AP demonstrated considerably greater factor activity. This would be beneficial when manufacturing clotting factor concentrates. Large scale clinical trials are needed to further address the hemostatic outcomes of both products in massively transfused patients.
