Stability of coagulation proteins in frozen plasma

Woodhams, Barry; Girardot, O; Blanco, Maria-Jose; Colesse, G; Gourmelin, Y.

doi:10.1097/00001721-200106000-00002

Cited by 161 publications

(131 citation statements)

References 4 publications

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“…22 However, studies have shown that INR for patients on anticoagulation therapy or PT in other clinical situations can be reliable even if determined on frozen plasmas. 29,30 Because both our calibration and standardization studies were performed on frozen plasmas, we do not believe that sample freezing could have influenced our data. Second, the WHO calibration model uses international reference thromboplastin preparation with a great responsiveness to the defect induced by the vitamin K antagonist with an ISI value close to 1.…”

Section: Discussionmentioning

confidence: 99%

A modified international normalized ratio as an effective way of prothrombin time standardization in hepatology

et al. 2007

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International Normalized Ratio (INR), which standardizes prothrombin time (PT) during oral anticoagulation, has been extended to standardize PT in liver diseases and is included in prognostic models such as the Model for End stage Liver Disease (MELD). However, mechanisms of PT prolongation in liver diseases differ from those involved in oral anticoagulation, and the thromboplastin reagents differ in their sensitivities to these 2 mechanisms. Our aim was to determine whether, in the calibration model for thromboplastins proposed by the World Health Organization, the use of plasmas from patients with liver diseases instead of plasmas from patients on oral anticoagulation could lead to a new INR specific for liver diseases (INR "LD"), achieving a real standardization of PT. First, 5 thromboplastins were calibrated against an international reference using 60 plasmas of patients with liver failure and, in a second step, the variation of PT reported as seconds, the ratio of patient PT to normal PT, See Editorial on Page 295 P rothrombin time (PT) is the usual test for monitoring oral anticoagulation by vitamin K antagonists 1 and is widely adopted to assess the severity of acute and chronic liver injury. 2 PT is the recalcification time of citrated plasma in the presence of a thromboplastin reagent. 3 The term thromboplastin refers to a complex mixture of tissue factor and phospholipids prepared from tissue extracts of animal or human origin. Recent thromboplastins contain recombinant tissue factor. PT is influenced by the levels of the following coagulation factors: I (fibrinogen), II, V, VII, and X, all factors being synthesized by the liver and, among them, 3 (II, VII, and X) being vitamin K dependent. Thromboplastins can vary markedly in their responsiveness to the defects induced by vitamin K antagonist therapy. As a result, the poor agreement between PT in different laboratories whatever the methods of reporting results 4 has led to important differences in oral anticoagulant dosing. 5,6 Standardization of PT reporting in patients on oral anticoagulation has been improved by the calibration model for thromboplastins proposed by the World Health Organization (WHO). 7 This system defines, for a specific thromboplastin reagent, the International Sensitivity Index (ISI) obtained by a calibration using plasmas of patients on stable oral anticoagulant doses, against a WHO international reference thromboplastin. 7 The ISI is a numerical value that reflects the responsiveness of a given thromboplastin to reduction of the vitamin K-dependent coagulation factors; the lower the ISI value, the greater the sensitivity of the reagent. The recommended scale of reporting PT results is

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Section: Discussionmentioning

confidence: 99%

A modified international normalized ratio as an effective way of prothrombin time standardization in hepatology

et al. 2007

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“…We also considered that the age and condition of the plasma samples, some of which had been in storage for up to 10 years and thus were at risk of deterioration, 17 might have affected the relationships between AF and our prothrombotic markers. Indeed, because 10 samples produced unreliable fibrinogen values, the remaining samples used may also have deteriorated from their original state, which may explain why we found no significant relationship between this marker and any clinical feature on univariate analysis (data not shown), despite the known association between fibrinogen and cardiovascular disease.…”

Section: Discussionmentioning

confidence: 99%

Atrial Fibrillation and the Prothrombotic State in the Elderly

Conway

Heeringa

Kuip

et al. 2003

Stroke

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Background and Purpose-Atrial fibrillation (AF) is a major cause of stroke among the elderly. Evidence for a prothrombotic state in AF is controversial, and there is a lack of studies among the elderly. We studied the relationships between AF and 3 prothrombotic plasma markers-von Willebrand factor (vWf; a marker of endothelial damage/ dysfunction), soluble P-selectin (sP-sel; a marker of platelet activation), and fibrinogen-in a matched case-control study nested within a large community-based study of an elderly population. Methods-We identified 162 elderly participants (meanϮSD age, 78Ϯ8 years; 51% male) in the Rotterdam Study with documented AF and matched each case by age and sex to 2 population controls. vWf and sP-sel were measured by enzyme-linked immunosorbent assay; fibrinogen was measured with the Clauss method. We used conditional logistic regression analysis to assess the relationships between the markers and AF, adjusting for potential confounders. Results-There were no significant relationships between either fibrinogen (Pϭ0.8) or sP-sel (Pϭ0.6) and AF. However, a positive linear relationship between vWf level and presence of AF remained significant after adjustment for potential confounders among women (odds ratio [OR], 1.17; 95% CI, 1.02 to 1.34) per 10-IU/dL increase in vWf but not among men (OR, 1.06; 95% CI, 0.96 to 1.17). Conclusions-We observed a positive relationship between AF and plasma vWf (or endothelial damage/dysfunction) in our elderly population, which was most apparent among women. Fibrinogen and sP-sel levels were unrelated to AF. The prothrombotic state of AF may be subject to sex differences, but longitudinal studies are needed to determine the relationship between these plasma markers and stroke risk.

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“…All investigations should therefore be completed within 4 h of sample collection or plasmas should be deep frozen within this time for future analysis. Clotting factor assay results are generally stable for samples stored at )24°C or lower for up to 3 months [13] and for samples stored at )74°C for up to 18 months (results within 10% of baseline defined as stable). Storage in domestic grade )20°C freezers is normally unacceptable.…”

Section: Sample Collection and Processingmentioning

confidence: 99%

The rare coagulation disorders – review with guidelines for management from the United Kingdom Haemophilia Centre Doctors' Organisation

et al. 2004

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Summary.The rare coagulation disorders are heritable abnormalities of haemostasis that may present significant difficulties in diagnosis and management. This review summarizes the current literature for disorders of fibrinogen, and deficiencies of prothrombin, factor V, FV + VIII, FVII, FX, the combined vitamin K-dependent factors, FXI and FXIII. Based on both collective clinical experience and the literature, guidelines for management of bleeding complications are suggested with specific advice for surgery, spontaneous bleeding, management of pregnancy and the neonate. We have chosen to include a section on Ehlers-Danlos Syndrome because haematologists may be consulted about bleeding manifestations in such patients.

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Stability of coagulation proteins in frozen plasma

Cited by 161 publications

References 4 publications

A modified international normalized ratio as an effective way of prothrombin time standardization in hepatology

A modified international normalized ratio as an effective way of prothrombin time standardization in hepatology

Atrial Fibrillation and the Prothrombotic State in the Elderly

The rare coagulation disorders – review with guidelines for management from the United Kingdom Haemophilia Centre Doctors' Organisation

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