Coagulation factor content of plasma produced from whole blood stored for 24 hours at ambient temperature: results from an international multicenter BEST Collaborative study

Abstract

These data show that there is minimal effect of storing whole blood at ambient temperature for 24 hours on the coagulation activity of plasma and that this is an acceptable alternative to producing plasma on the day of blood collection.

Quality Assessment of Established and Emerging Blood Components for Transfusion

“…van der Meer and de Korte also reported no effect of active cooling of whole blood held overnight on FVIII activity in generated plasma [61]. These results on holding effects have in general been replicated by investigators using different whole blood processing methods and different anticoagulants in different nations and transfusion services [36, 62–66]. There is no evidence that the declines in coagulation factor activity associated with holding effects compromise clinical efficacy, and therefore economic and strategic considerations have prompted greater use of FP-type plasmas over FFP [42, 67].…”

“…FVIII was the most affected factor, declining 23% on average relative to the shorter hold; FV, FVII, FXI, FXII, FXIII, VWF, and antithrombin were unaffected. FII, FIX, and FX declined <5%, while Proteins C and S lost 6 and 14% activity, respectively [36]. A stability study of thawed refrigerated plasma over 120 hours showed that FVIII and FV activity significantly declined, by 8.5% and 27% within 24 hours, but that fibrinogen remained stable and that FVII remained stable for 48–72 hours of refrigerated storage [37].…”

The Effect of Holding Times of Whole Blood and Its Components During Processing on In Vitro and In Vivo Quality

“…An evaluation of 9 clotting factors showed the same pattern as others [36]. Finally, a multisite study of the BEST Collaborative [52] demonstrated a 6% lower protein C and a 14% lower protein S, but no change in antithrombin for whole blood held for 24 to 26 vs less than 8 hours in a paired study; factor VIII was 23% lower.…”

“…However, the overall functionality of the plasma seems unaffected [52]. Other factors show some fluctuations between publications, but fall within the biological variation among blood donors and the analytical variation of the tests used.…”

“…Optimal when leukoreduction performed after 8-to 24-h room temperature hold (shown for buffy coat-derived platelets only) [7,[56][57][58][59][60][61] Plasma Factor VIII 10%-30% lower, but clinical consequence probably low [3,6,13,14,19,[47][48][49][50][51][52] Other clotting factors no effect [13,19,47,[49][50][51][52] Details are given in the text.…”