Thrombin generation potential and clot‐forming capacity of thawed fresh‐frozen plasma, plasma frozen within 24 h and solvent/detergent‐treated plasma (octaplas<scp>LG</scp><sup>®</sup>), during 5‐day storage at 1–6°C

Heger, Andrea; Neisser-Svae, Andrea; Trawnicek, Laurenz; Triulzi, Darrell J.

doi:10.1111/vox.12656

Cited by 5 publications

(9 citation statements)

References 9 publications

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“…This is different from another study which did not report significant differences between the D4 and D0 ETP values . On the other hand, a more recent published study (involving FP24 instead of RTFP24) showed similar decline in all CAT parameters after 120 h post‐thaw .…”

Section: Discussioncontrasting

confidence: 99%

“…While there is published literature establishing the equivalence between FFP and RTFP24 upon thawing, few have compared global assays of haemostasis like thrombin generation. There were also less published literature reports on extended storage of thawed RTFP24 as most were conducted on thawed FFP or FP24 , and most did not directly compare RTFP24 with FFP beyond 24 h post‐thaw.…”

Section: Introductionmentioning

confidence: 99%

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Ex vivo haemostatic capacity of plasma upon thawing and beyond: a comparison between fresh frozen plasma (FFP) and frozen plasma prepared from whole blood stored at room temperature up to 24 hours postcollection (RTFP24)

et al. 2019

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Background/objectives We compared the ex vivo haemostatic capacity of RTFP24 with FFP upon thawing and >24 h post‐thaw. We included thrombin generation (TG) as few studies had compared global haemostatic function, and most did not directly compare RTFP24 with FFP >24 h post‐thaw. Materials/methods Twenty units each of RTFP24 and FFP were measured for coagulation factors and thrombin generation upon thawing (D0) and 4 days post‐thaw (D4). Labile factors were also measured from D1 to D3. 10 single cryoprecipitate units were each prepared from FFP and RTFP24, and measured for FXIII, FVIII and fibrinogen at D0. Results At D0, RTFP24 was comparable to FFP except for lower FV, protein S, endogenous thrombin potential (ETP) and higher FXIII. These differences were likely clinically insignificant since 95% and 80% of RTFP24 met our laboratory's reference ranges for FV/protein S and ETP, respectively. There were no differences between RTFP24‐ and FFP‐derived cryoprecipitate. At D4, RTFP24 was comparable to FFP except for lower FV, ETP, and higher FXI and FXIII. More RTFP24 than FFP had ETP lower than our laboratory's reference range (45% vs 15%). Multiple coagulation factors and all TG parameters declined from their respective baselines. The percentage declines were comparable or less in RTFP24, except for protein C, fibrinogen and time to peak. Conclusion RTFP24 and FFP, and their derived cryoprecipitate have comparable haemostatic capacity upon thawing. RTFP24 has poorer TG potential than FFP >24 h post‐thaw, not supporting universal extension of RTFP24's shelf life except to facilitate urgent transfusions for massive haemorrhage.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ex vivo haemostatic capacity of plasma upon thawing and beyond: a comparison between fresh frozen plasma (FFP) and frozen plasma prepared from whole blood stored at room temperature up to 24 hours postcollection (RTFP24)

et al. 2019

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“…Several in vitro studies reported that factor activity in S/D plasma thawed for more than 24 hours remains high enough for clinical use. 5,32,33 Although labile factors, such as Factor V, VII and VIII can decline during 5-day storage, levels remained comparable to those in TP. The present retrospective study provides preliminary clinical evidence that T-S/D can correct coagulopathies as well as TP and the use of T-S/D does not have an adverse effect on in-hospital mortality, readmission rates, LOS and in-hospital DVT.…”

Section: Discussionmentioning

confidence: 96%

“…These in vitro studies evaluated factor antigen levels and activity of the plasma units, finding T-S/D equivalent to TP. [32][33][34][35] In 2016, our institution extended the expiration date of S/D plasma from 24 hours to 5 days post-thaw and implemented T-S/D as a routine plasma product. The aim of this retrospective pilot study was to determine whether T-S/D is clinically equivalent to TP.…”

Section: Introductionmentioning

confidence: 99%

Thawed solvent/detergent‐treated plasma demonstrates comparable clinical efficacy to thawed plasma

et al. 2020

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Background Thawed Plasma (TP), plasma thawed and refrigerated for up to 5 days, is a commonly transfused plasma product. This pilot study was conducted to determine whether Thawed Solvent/Detergent‐treated Plasma stored refrigerated for up to 5‐days post‐thaw (T‐S/D) was as efficacious as TP. Study Design and Methods This single institution retrospective cohort analysis evaluated the efficacy of T‐S/D in reversing coagulopathies in comparison to TP. Utilizing the institution's electronic medical records, transfusion data were collected in adult patients who received either TP or T‐S/D. The primary outcome was the incidence of subsequent transfusions within 24 hours after first dose of either type of plasma. Secondary outcomes included the number of blood products transfused within 24 hours of first‐dose plasma, correction of pre‐transfusion coagulation laboratory values, volume transfused, and clinical outcomes. Results TP was received by 301 patients and 137 received T‐S/D during the first 32 months post‐implementation of T‐S/D. There was no difference in incidence of subsequent transfusions or number of blood products given. The median pre‐INR of both the TP and T‐S/D cohorts was 1.9, with a similar decrease in INR of 0.2 and 0.3 (p = 0.36), respectively, post plasma transfusion. There was no difference in correction of PT/aPTT, mortality, transfusion reactions, readmission rates, length of stay, or inpatient deep venous thrombosis. The median volume of T‐S/D plasma transfused for the first dose was 126 mL less than TP (p = .0001). Conclusion T‐S/D was as efficacious as TP for the treatment of coagulopathies and the reversal of coagulation laboratory values.

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“… 148 Coagulation factor levels after 5 days of storage of thawed solvent-/detergent-treated pooled plasma are essentially the same as found in thawed single-donor plasma. 149 In the US, the FDA currently approves use of octaplast for acquired factor-deficiency coagulopathies due to liver disease or that develop during the course of cardiovascular surgical procedures and liver transplantation. 150…”

Section: Damage Control Resuscitationmentioning

confidence: 99%

Optimizing transfusion strategies in damage control resuscitation: current insights

Pohlman

Fecher

Arreola-Garcia

2018

JBM

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From clinical and laboratory studies of specific coagulation defects induced by injury, damage control resuscitation (DCR) emerged as the most effective management strategy for hemorrhagic shock. DCR of the trauma patient who has sustained massive blood loss consists of 1) hemorrhage control; 2) permissive hypotension; and 3) the prevention and correction of trauma-induced coagulopathies, referred to collectively here as acute coagulopathy of trauma (ACOT). Trauma patients with ACOT have higher transfusion requirements, may eventually require massive transfusion, and are at higher risk of exsanguinating. Distinct impairments in the hemostatic system associated with trauma include acquired quantitative and qualitative platelet defects, hypocoagulable and hypercoagulable states, and dysregulation of the fibrinolytic system giving rise to hyperfibrinolysis or a phenomenon referred to as fibrinolytic shutdown. Furthermore, ACOT is a component of a systemic host defense dysregulation syndrome that bears several phenotypic features comparable with other acute systemic physiological insults such as sepsis, myocardial infarction, and postcardiac arrest syndrome. Progress in the science of resuscitation has been continuing at an accelerated rate, and clinicians who manage catastrophic blood loss may be incompletely informed of important advances that pertain to DCR. Therefore, we review recent findings that further characterize the pathophysiology of ACOT and describe the application of this new information to optimization of resuscitation strategies for the patient in hemorrhagic shock.

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Thrombin generation potential and clot‐forming capacity of thawed fresh‐frozen plasma, plasma frozen within 24 h and solvent/detergent‐treated plasma (octaplasLG^®), during 5‐day storage at 1–6°C

Cited by 5 publications

References 9 publications

Ex vivo haemostatic capacity of plasma upon thawing and beyond: a comparison between fresh frozen plasma (FFP) and frozen plasma prepared from whole blood stored at room temperature up to 24 hours postcollection (RTFP24)

Ex vivo haemostatic capacity of plasma upon thawing and beyond: a comparison between fresh frozen plasma (FFP) and frozen plasma prepared from whole blood stored at room temperature up to 24 hours postcollection (RTFP24)

Thawed solvent/detergent‐treated plasma demonstrates comparable clinical efficacy to thawed plasma

Optimizing transfusion strategies in damage control resuscitation: current insights

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Thrombin generation potential and clot‐forming capacity of thawed fresh‐frozen plasma, plasma frozen within 24 h and solvent/detergent‐treated plasma (octaplasLG®), during 5‐day storage at 1–6°C

Cited by 5 publications

References 9 publications

Ex vivo haemostatic capacity of plasma upon thawing and beyond: a comparison between fresh frozen plasma (FFP) and frozen plasma prepared from whole blood stored at room temperature up to 24 hours postcollection (RTFP24)

Ex vivo haemostatic capacity of plasma upon thawing and beyond: a comparison between fresh frozen plasma (FFP) and frozen plasma prepared from whole blood stored at room temperature up to 24 hours postcollection (RTFP24)

Thawed solvent/detergent‐treated plasma demonstrates comparable clinical efficacy to thawed plasma

Optimizing transfusion strategies in damage control resuscitation: current insights

Contact Info

Product

Resources

About

Thrombin generation potential and clot‐forming capacity of thawed fresh‐frozen plasma, plasma frozen within 24 h and solvent/detergent‐treated plasma (octaplasLG^®), during 5‐day storage at 1–6°C