Cardigan Rebecca, Lawrie Andrew S, Mackie Ian J, Williamson Lorna M
National Blood Service, England & North Wales, UK.
Transfusion. 2005 Aug;45(8):1342-8. doi: 10.1111/j.1537-2995.2005.00219.x.
The aim of this study was to assess whether the quality of FFP produced from whole blood stored at 4 degrees C overnight is adequate for its intended purpose.
Fresh-frozen plasma (FFP) separated from whole blood (n = 60) leukodepleted (LD) after storage at 4 degrees C overnight (18-24 hr from donation, Day 1 FFP) was compared with that LD within 8 hours of donation (Day 0 FFP, the current standard method).
In more than 95 percent of Day 1 FFP units, levels of factor (F) II, FV, FVII, FVIII, F IX, FX, FXI, and FXII were greater than 0.50 U per mL except for von Willebrand factor (VWF) antigen and FVIII, where 92 and 87 percent of units, respectively, contained greater than 0.50 IU per mL. Compared with historical data on FFP stored for 8 hours, fibrinogen, FV, FVIII, and FXI were reduced by 12, 15, 23, and 7 percent, respectively, but other factors were not significantly reduced. Levels of VWF-cleaving protease activity were not different between FFP prepared from paired units of blood (n = 3) held for 8 or 24 hours, but were below the reference range in an additional 2 of 6 units held for 24 hours. The activities of protein S, protein C, antithrombin III, and alpha(2)-antiplasmin were reduced by less than 10 percent in Day 1 FFP (n = 20), but with final levels above the lower limit of the normal range in greater than 95 percent of units. Activated FXII antigen was not significantly raised in plasma stored for 18 to 24 hours, but levels of prothrombin fragment 1 + 2 were slightly increased (0.88 ng/mL, 18-24 hr; 0.65 ng/mL, < 8 hr).
These data suggest that there is good retention of relevant coagulation factor activity in plasma produced from whole blood stored at 4 degrees C for 18 to 24 hours and that this would be an acceptable product for most patients requiring FFP.
本研究旨在评估4℃过夜储存的全血所制备的新鲜冰冻血浆(FFP)质量是否能满足其预期用途。
将4℃过夜储存(献血后18 - 24小时,第1天FFP)后白细胞滤除(LD)的全血(n = 60)所分离的新鲜冰冻血浆与献血后8小时内白细胞滤除的血浆(第0天FFP,当前标准方法)进行比较。
在超过95%的第1天FFP单位中,除血管性血友病因子(VWF)抗原和FVIII外,因子(F)II、FV、FVII、FVIII、FIX、FX、FXI和FXII的水平均大于0.50 U/mL,其中分别有92%和87%的单位其含量大于0.50 IU/mL。与储存8小时的FFP历史数据相比,纤维蛋白原、FV、FVIII和FXI分别降低了12%、15%、23%和7%,但其他因子无显著降低。从成对血液单位(n = 3)制备的FFP中,储存8小时或24小时的VWF裂解蛋白酶活性水平无差异,但在另外2个储存24小时的6个单位中低于参考范围。第1天FFP(n = 20)中蛋白S、蛋白C、抗凝血酶III和α(2)-抗纤溶酶的活性降低小于10%,但超过95%的单位最终水平高于正常范围下限。储存18至24小时的血浆中活化FXII抗原无显著升高,但凝血酶原片段1 + 2水平略有升高(18 - 24小时为0.88 ng/mL;< 8小时为0.65 ng/mL)。
这些数据表明,4℃储存18至24小时的全血所产生的血浆中相关凝血因子活性保留良好,对于大多数需要FFP的患者而言,这将是一种可接受的产品。