Liquid Plasma vs Thawed Plasma: Tracking Coagulation Factor Activity Changes During Storage

Liquid plasma (LQP) stands out as an alternative to thawed plasma (TP) for emergent transfusions due to longer shelf life. We aim to measure fibrinogen, Protein C, Protein S, FV, FVII, and FVIII activity in LQP, quantify how these factors levels change in LQP during storage, and characterize how they compare in LQP to TP.

Coagulation factor activities were measured on Days 15, 26, and 27 for LQP (n=26) and Day 5 for TP (n=24). Bayesian statistical modeling was used to compare coagulation factor activity and quantify changes in activity during storage.

Fibrinogen and Protein C activity in Day 26 LQP (LQP26) was comparable to Day 5 TP (TP5) with posterior mean activity of 252 mg/dL vs 247 mg/dL and 100.4% vs 111.3%, respectively. FV, FVII, and FVIII had slightly lower activity in LQP26 vs TP5 with posterior mean activities of 42.6% vs 58.4%, 55.0% vs 62.2%, and 48.8% vs 55.0%, respectively. Protein S in LQP26 was low with posterior mean activity of 28.0%, which was slightly less than half that of TP5 at 64.9%. From Day 15 to Day 26, FVII in LQP decreased at a rate of -3.49% per day whereas fibrinogen, Protein C, Protein S, FV, and FVIII activity in LQP remained relatively stable.

Compared to TP5, LQP26 has comparable activities of fibrinogen, Protein C, FV, FVII, and FVII but lower activity of Protein S. LQP is a viable alternative for use in emergency transfusions and massive transfusion protocols.

Liquid plasma factor activities, with the exception of protein S, are comparable to thawed plasma in terms of emergency use with the advantage of extended shelf life.Liquid plasma has adequate fibrinogen and Protein C levels on the last day of expiration.Liquid plasma has ∼50% FV, FVII and FVIII levels on the last day of expiration, making it a sufficient replacement option to TP for active bleeding.