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Stability of plasma fibrinogen during storage of platelet concentrates at 22 degrees C
Insights
Plasma fibrinogen in platelet concentrates (PC) remains stable during storage. This finding supports the use of stored PC for patients experiencing massive hemorrhage, ensuring essential coagulation factors are available.
Area of Science:
- Transfusion Medicine
- Hematology
- Biochemistry
Background:
- Platelet concentrates (PC) are transfused with significant amounts of plasma.
- The integrity of plasma fibrinogen and other coagulation factors during PC storage is crucial for clinical efficacy.
Purpose of the Study:
- To evaluate the stability and functional integrity of fibrinogen in stored platelet concentrates (PC).
- To assess the impact of PC storage on other key coagulation factors.
Main Methods:
- Assessed fibrinogen concentration, thrombin time, and fibrin monomer polymerization in stored PC.
- Analyzed A alpha, B beta, and gamma chain mobility via SDS-PAGE.
- Quantified fibrinogen-fibrin degradation products and performed gel filtration chromatography on radiolabeled fibrinogen.
Main Results:
- Fibrinogen concentration and functional assays (thrombin time, polymerization) remained normal after storage.
- No significant fibrinogen-fibrin degradation products were detected.
- Radiolabeled fibrinogen studies indicated no significant proteolytic activity generation during storage.
- Factor V and VIII levels decreased (40-65%), while Factors IX, X, and XI remained stable.
Conclusions:
- Plasma fibrinogen is remarkably stable during standard PC storage (5 days at 22°C).
- Key coagulation factors, apart from Factors V and VIII, show good stability.
- Stored PC can provide valuable fibrinogen and other coagulation factors for patients with massive hemorrhage.
Abstract:
Platelet concentrates (PC) are stored for up to 5 days at 22 degrees C prior to infusion. Since considerable suspending plasma is infused with the platelets, we examined the integrity of plasma fibrinogen from stored PC. The concentration of fibrinogen after storage was normal. After purification, fibrinogen from stored PC had normal thrombin time and rate of polymerization of fibrin monomer, and after reduction, its A alpha, B beta, and gamma chains had normal mobility on sodium dodecyl sulfate polyacrylamide gel electrophoresis. Assays of plasma from stored PC for fibrinogen-fibrin degradation products were negative. When 125I-fibrinogen was added to PC prior to storage and supernatant plasma was filtered in a sepharose 4B column after storage, radioactivity eluted in a single, symmetrical peak with no evidence for formation of low or high molecular weight material. These results make it unlikely that thrombin, plasmin, or other proteolytic activity is generated during storage. The levels of factors V and VIII fell to 40 to 65 percent of control values while the activities of factors IX, X, and XI did not change significantly during storage. We conclude that suspending plasma fibrinogen and other coagulation factors are remarkably stable during PC storage. They should be of value during the support of patients with massive hemorrhage.