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解冻血浆和血小板浓缩物的凝血酶生成及凝血因子含量。

Thrombin generation and coagulation factor content of thawed plasma and platelet concentrates.

作者信息

Cookson P, Lawrie A, Green L, Dent E, Proffitt S, Bashir S, Thomas S, Cardigan R

机构信息

Component Development Laboratory, NHS Blood & Transplant, Brentwood, UK.

出版信息

Vox Sang. 2015 Feb;108(2):160-8. doi: 10.1111/vox.12206. Epub 2014 Dec 3.

Abstract

BACKGROUND

We assessed the haemostatic capacity of thawed plasma produced after ambient storage of whole blood for 24 h (RTFP24), and the supernatant of buffy-coat derived platelet concentrates (PC).

METHODS

Platelet concentrates (n = 20) were tested on days 1, 5 and 7 of storage at 22°C and RTFP24 (n = 10) immediately following thawing and after 4 and 6 days storage at 4°C. Coagulation factor activity, thrombin generation ± an activator of protein C (PROTAC) and rotational thromboelastometry (ROTEM) were assessed.

RESULTS

In plasma and buffy-coat derived PC, there was a < 10% loss of factors II, IX and FX, but much higher loss of factors FV, FVII and FVIII. In plasma, the total or peak amount of thrombin generated was unaffected by storage for 6 days, with or without Protac, but there was an increase in lag time and decreased rate of clot formation by ROTEM. In PC, but not plasma, there was a 16% increase in FXII activity and increase in resistance to activated protein C, co-incidental to 30% loss of free protein S.

CONCLUSIONS

These data suggest thrombin generation is relatively unaltered when RTFP24 is thawed and stored for 6 days, and that the supernatant of PC has significant haemostatic capacity.

摘要

背景

我们评估了全血在室温下储存24小时后产生的解冻血浆(RTFP24)以及来自富血小板血浆浓缩物(PC)的上清液的止血能力。

方法

对20份血小板浓缩物在22°C储存的第1、5和7天进行测试,对10份RTFP24在解冻后以及在4°C储存4天和6天后进行测试。评估凝血因子活性、凝血酶生成±蛋白C激活剂(PROTAC)以及旋转血栓弹力图(ROTEM)。

结果

在血浆和来自富血小板血浆的PC中,凝血因子II、IX和FX的损失<10%,但凝血因子FV、FVII和FVIII的损失要高得多。在血浆中,无论有无Protac,储存6天后凝血酶生成的总量或峰值不受影响,但ROTEM显示延迟时间增加且凝块形成速率降低。在PC中而非血浆中,FXII活性增加了16%,对活化蛋白C的抗性增加,同时游离蛋白S损失了30%。

结论

这些数据表明,RTFP24解冻并储存6天后凝血酶生成相对未改变,并且PC的上清液具有显著的止血能力。

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