Incidence of Transfusion Reactions and Retention of Procoagulant and Anticoagulant Factor Activities in Equine Plasma

Abstract

Background: The extent of preservation of clotting factors and incidence of transfusion reactions to noncommercial equine plasma is not documented.Hypothesis: Equine frozen plasma would retain its coagulation factor activity within the reference range and the incidence of transfusion reactions would be low.Animals: Ten plasma donor horses. Fifty clinically ill hospitalized horses receiving plasma were reviewed to determine the incidence of reactions.Methods: In vitro study and retrospective case review. Plasma was prepared by gravity sedimentation from whole blood refrigerated for 48 hours. The activities of factors VII through XII, antithrombin (AT), and Protein C were measured. Factor activities were compared for plasma samples obtained before blood collection (S0), after 48 hours of gravity sedimentation at 5 1C and after plasma separation (S1), and after 90 days of storage at À20 1C (S90). The medical records of 50 consecutive clinically ill horses receiving frozen plasma were reviewed to determine the incidence of transfusion reactions.Results: The combined effect of plasma harvest, gravity sedimentation, decantation, and freezing caused significant reductions in factors IX, (43% P 5 .0013), X, (33% P 5 .0001), XI, (48% P 5 .0008), AT, (10% P 5 .02), and Protein C (26% P 5 .0001). Activities for all factors analyzed, except factor X, remained within the reference ranges. Transfusion reactions were recorded for 5/50 horses.Conclusions and Clinical Relevance: Clotting factors, AT, and Protein C were well preserved. The incidence of reactions to frozen plasma was 10%.

Characterisation of clotting factors, anticoagulant protein activities and viscoelastic analysis in healthy donkeys

“…Clotting factor activities in horses in the current study differed slightly from those reported previously . These differences may relate to the numbers of animals used, to inter‐laboratory differences or to breed differences .…”

“…No differences were found between species for Factors V and VIII. Activity of Factor XI was more than twice as high in donkeys as in horses and its concentrations were markedly outwith the ranges reported in a previous study conducted in horses (Supplementary Item ). The other factors in the contact system pathway showed heterogeneous results.…”

Acute normovolaemic haemodilution in a Clydesdale gelding prior to partial resection of the left ventral concha under general anaesthesia

“…; Wilson et al . ). The lifespan of transfused autologous erythrocytes is significantly longer than their allogenic counterparts, although lifespan is influenced by storage duration.…”

“…Advantages include a longer lifespan of the transfused erythrocytes and minimised risk of transfusion reactions (Mudge et al 2004). Transfusion reactions can be immunemediated or nonimmune-mediated, immediate or delayed and are more common with whole blood (16%, Hurcombe et al 2007) compared to plasma (0-10%, Hardefeldt et al 2009;Wilson et al 2009). The lifespan of transfused autologous erythrocytes is significantly longer than their allogenic counterparts, although lifespan is influenced by storage duration.…”

Autologous blood transfusion following an allogenic transfusion reaction in a case of acute anaemia due to intra-abdominal bleeding

“…Transfusion of whole blood or blood products is a commonly performed procedure in the hospitalised horse, Auto-transfusion in a case of haemoabdomen either for treatment of haemorrhage or anaemia, using whole blood or packed red blood cells (RBC) or as a supportive measure for systemically ill horses suffering from a range of disorders such as hypoalbuminaemia, systemic inflammation, sepsis, disseminated intravascular coagulation or immune mediated thrombocytopaenia using fresh, frozen or platelet-rich plasma. Transfusion reactions are a recognised complication of administration of blood products in the horse and have been reported more commonly with administration of whole blood (16%, Hurcombe et al 2007) compared to plasma (0-10%, Hardefeldt et al 2009;Wilson et al 2009). Frequently, blood typing and cross-matching are not performed prior to the first administration of whole blood, due to the relatively low risk of a reaction if no previous transfusions have been administered and the impracticality of performing a cross-match in an emergency situation.…”