Buchta C, Felfernig M, Höcker P, Macher M, Körmöczi G F, Quehenberger P, Heinzl H, Knöbl P
Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria.
Vox Sang. 2004 Oct;87(3):182-6. doi: 10.1111/j.1423-0410.2004.00552.x.
Transfusion of fresh-frozen plasma is still a pillar in emergency medicine for using to prevent dilutional coagulopathy or disseminated intravascular coagulation after severe blood loss, but thawing procedures can delay its availability. On the other hand, the wastage of plasma, once thawed and not transfused within a defined time-period, represents an inefficient handling of economic resources and is contradictory to blood donor intentions. In this study we investigated the stability of coagulation factor activities and plasma protein levels during 6 days of storage of thawed solvent/detergent (S/D)-treated plasma at +4 degrees C. Our results may form the basis for reconsideration of expiry times of thawed S/D-treated plasma.
Five units of S/D-treated plasma (Octaplas) were thawed and warmed to 20 degrees C, then recooled and stored at +4 degrees C for 6 days. The activities of coagulation factors II, V, VII, VIII, IX, X, XI and XII, fibrinogen, antithrombin (AT), protein C, protein S and von Willebrand factor antigen (vWF:Ag) were measured on days 0, 1, 2, 3 and 6.
Except for protein S, the activities of all coagulation factors and inhibitors were at least 0.5 U/ml during storage at 4 degrees C for 6 days. The mean levels, during storage, of factors IX, X, XI and XII, vWF:Ag, fibrinogen and protein C were at least 94%, and of factors II, V and VIII, and AT at least 78%, of the levels immediately after thawing; the activity of factor VII decreased to 83% and of protein S to 43% of the baseline values.
Thawed S/D-treated plasma stored at +4 degrees C for up to 6 days still contains sufficient coagulation activities and plasma proteins to be regarded as suitable for transfusion in the established indications.
新鲜冰冻血浆的输注仍是急诊医学中的一项重要手段，用于预防严重失血后稀释性凝血障碍或弥散性血管内凝血，但解冻过程会延迟其可用性。另一方面，血浆一旦解冻且在规定时间内未输注，就会造成浪费，这是对经济资源的低效利用，也违背了献血者的意愿。在本研究中，我们调查了经溶剂/去污剂（S/D）处理的解冻血浆在4℃储存6天期间凝血因子活性和血浆蛋白水平的稳定性。我们的研究结果可能为重新考虑经S/D处理的解冻血浆的有效期奠定基础。
将5单位经S/D处理的血浆（Octaplas）解冻并加热至20℃，然后重新冷却并在4℃储存6天。在第0、1、2、3和6天测量凝血因子II、V、VII、VIII、IX、X、XI和XII、纤维蛋白原、抗凝血酶（AT）、蛋白C、蛋白S和血管性血友病因子抗原（vWF:Ag）的活性。
除蛋白S外，所有凝血因子和抑制剂在4℃储存6天期间的活性至少为0.5 U/ml。在储存期间，因子IX、X、XI和XII、vWF:Ag、纤维蛋白原和蛋白C的平均水平至少为解冻后即刻水平的94%，因子II、V和VIII以及AT的平均水平至少为解冻后即刻水平的78%；因子VII的活性降至基线值的83%，蛋白S的活性降至基线值的43%。
经S/D处理的解冻血浆在4℃储存长达6天仍含有足够的凝血活性和血浆蛋白，可被视为适用于既定适应证的输血。
