Dhantole Lalit, Dubey Anju, Sonker Atul
Department of Transfusion Medicine, Fortis Hospital Mulund, Mumbai, India.
Department of Transfusion Medicine, Super Speciality Cancer Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Asian J Transfus Sci. 2019 Jan-Jun;13(1):23-29. doi: 10.4103/ajts.AJTS_139_17.
Fresh frozen plasma (FFP) is administered to correct deficiencies of various coagulation factors. The level of these factors in FFP varies with donor demographics and ex-vivo processing of plasma. In this study we have compared the quality control parameters of FFP collected from donors of different genders, age groups, ABO blood groups, smoking and alcohol intake habits.
Four ABO group matched plasma units were pooled, split and further processed by four different freeze-thaw algorithms: frozen by contact shock freezer; thawed at 37°C, frozen by contact shock freezer; thawed at 45°C, frozen by mechanical freezer; thawed at 37°C, frozen by mechanical freezer; thawed at 45°C. The coagulation factor levels in plasma units were compared.
There were no significant differences in the quality parameters with donor age, gender and alcohol intake. Factor VIII levels were significantly lower in O group FFP ( < 0.05). Smokers had significantly higher levels of fibrinogen ( < 0.05). There were no significant differences in PT, fibrinogen and factor VII levels of FFP processed through various algorithms. Plasma frozen rapidly through contact shock freezer had significantly lower aPTT and higher levels of factor V and VIII compared to mechanical freezing. There were no significant differences between PT, aPTT, fibrinogen, factor V, factor VII and factor VIII levels of FFP thawed at 37°C and 45°C. Mean thawing time was 28 minutes at 37°C and 17 minutes at 45°C.
Rapid freezing is recommended for optimum preservation of coagulation factors. Thawing may be done at 45°C in cases of emergency, without compromising hemostatic potential.
新鲜冰冻血浆（FFP）用于纠正各种凝血因子缺乏。FFP中这些因子的水平随献血者人口统计学特征及血浆的体外处理而变化。在本研究中，我们比较了从不同性别、年龄组、ABO血型、吸烟和饮酒习惯的献血者采集的FFP的质量控制参数。
将四个ABO血型匹配的血浆单位合并、分割，并通过四种不同的冻融算法进一步处理：通过接触式冲击冷冻机冷冻；在37°C解冻，通过接触式冲击冷冻机冷冻；在45°C解冻，通过机械冷冻机冷冻；在37°C解冻，通过机械冷冻机冷冻；在45°C解冻。比较血浆单位中的凝血因子水平。
质量参数在献血者年龄、性别和饮酒方面无显著差异。O型FFP中因子VIII水平显著较低（<0.05）。吸烟者的纤维蛋白原水平显著较高（<0.05）。通过各种算法处理的FFP的PT、纤维蛋白原和因子VII水平无显著差异。与机械冷冻相比，通过接触式冲击冷冻机快速冷冻的血浆aPTT显著较低，因子V和VIII水平较高。在37°C和45°C解冻的FFP的PT、aPTT、纤维蛋白原、因子V、因子VII和因子VIII水平无显著差异。37°C时平均解冻时间为28分钟，45°C时为17分钟。
建议快速冷冻以最佳保存凝血因子。在紧急情况下，可在45°C解冻，而不影响止血潜力。
