Assessment of factor-VIII levels in thawed fresh frozen plasma stored at 2°C-6°C for 5 days

Plasma is the cell-free part of blood prepared either from whole blood or by plasmapheresis. Fresh frozen plasma (FFP) must be stored at -18°C or colder and has a shelf life of 12 months. In routine practice, after thawing, FFP is stored for 24 h at 1°C-6°C if not transfused, and subsequently, it is discarded, leading to the wastage of valuable resources. This study measured the changes of coagulation factor VIII (FVIII) activities over 5 days in thawed FFP.

The objective of the study was to assess FVIII levels in thawed FFP immediately after thawing and after storage at 2°C-6°C for 24 h, 72 h, and 120 h and thereby to assess whether thawed FFP stored for 5 days can be considered to ameliorate coagulation factor deficiencies in affected patients.

100 blood donors, 25 each from A, B, AB, and O blood groups were randomly selected. Coagulation test parameters, prothrombin time, activated partial thromboplastin time, and FVIII:C, were measured at 0, 24, 72, and 120 h using an ACL ELITE PRO coagulometer (Instrumentation Laboratory, USA). Measurements of coagulation factors were conducted using one-stage clotting factor assays. Data were analyzed statistically using analysis of variance and paired t-test.

The average FVIII activity immediately after thawing (0 h) was 137.1%. FVIII activities were reduced significantly (P < 0.05) from 0 h to 120 h of storage at 2°C-6°C. A maximum decrease was seen in the first 24 h after thawing. The average FVIII activity at 120 h was 66.75%.

Coagulation FVIII activities in thawed FFP on Day 5 were still sufficient to treat bleeding patients as the activities were more than 30%. Therefore, thawed FFP stored for 5 days can be considered for use in needy patients in emergency cases as it can ensure immediate availability as well as the reduction in wastage. However, further research and clinical trials are necessary to confirm these findings.