Liquid plasma versus 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 its longer shelf-life. We aimed to measure fibrinogen, protein C (PC), protein S (PS), factor V (FV), factor VII (FVII) and factor VIII (FVIII) activity in LQP, quantify how these factors' levels change during storage and characterize how they compare in LQP and TP.

Coagulation factor activities were measured on days 15, 26 and 27 for LQP (n = 26) and Day 5 for TP (n = 31). Bayesian statistics was used to compare coagulation factor activity and quantify changes in activity during storage.

Fibrinogen and PC activity on Day 26 in LQP (LQP26) was comparable to that on Day 5 in TP (TP5) with posterior mean activity of 257 versus 246 mg/dL and 100.4% versus 108.7%, respectively. FV, FVII and FVIII had lower activity in LQP26 compared to TP5, with posterior mean activities of 42.6% versus 72.0%, 55.0% versus 59.7% and 48.8% versus 59.2%, respectively. PS in LQP26 was low, with posterior mean activity of 28.0%, which was less than half that of TP5 at 66.4%. From Day 15 to Day 26, FVII in LQP decreased at a rate of 3.49% per day, whereas fibrinogen, PC, PS, FV and FVIII activity in LQP remained relatively stable.

LQP26 has comparable activities of fibrinogen, PC and FVII as TP5, lower activities of FV and PS and slightly lower activity of FVIII. LQP is a viable alternative for use in emergency transfusions and massive transfusion protocols.