Israel Defense Forces (IDF) Medical Corps, Tel Aviv, Israel.
Hadassah Medical Center, Jerusalem, Israel.
Transfusion. 2021 May;61(5):1570-1577. doi: 10.1111/trf.16319. Epub 2021 Feb 17.
This prospective study evaluated the effect of routine, uncontrolled, Israeli field storage conditions on the safety and efficacy of Lyo-Plas N Freeze-Dried Plasma (FDP) at the end of the manufacturer's shelf life, and up to 24 months post expiry. Clotting factors V, VIII and XI, proteins S, C, fibrinogen, PTT, ATIII, VWF, and INR as well as TEG, DDM, residual moisture, pH, and sterility of FDP returned from field units after uncontrolled storage were evaluated.
Parameters measured at the end of manufacturer shelf life, as well as 6, 12, 18, and 24 months after expiry, were compared to those of freshly supplied FDP doses.
Changes were found when comparing freshly supplied FDP to all field-stored groups in INR, PT, PTT, pH, fibrinogen, and factor VIII. A significant change was also seen in Factor XI in the 12, 18, and 24 months post-expiry samples, Factor V and R in the 24 months post-expiry samples, MA in the 12, 24 months post-expiry group, and Protein C in the 18 months post-expiry group. An increase in the residual moisture from 0.90% in freshly supplied FDP to 1.35% in 24 months post-expiry FDP.; all p < .05. No growth was found in sterility analysis.
Despite uncontrolled field storage conditions, the findings demonstrate that the safety and efficacy of FDP units, stored in uncontrolled conditions are only slightly affected, even beyond their expiration date. This information allows consideration of possibly extending the shelf life.
本前瞻性研究评估了在制造商保质期结束后,以及在过期后 24 个月内,未经控制的以色列野外储存条件对 Lyo-Plas N 冻干血浆(FDP)的安全性和有效性的影响。评估了从野外单位返回后未经控制储存的 FDP 的凝血因子 V、VIII 和 XI、蛋白 S、C、纤维蛋白原、PTT、ATIII、VWF 和 INR 以及 TEG、DDM、残余水分、pH 值和无菌性。
在制造商保质期结束时以及过期后 6、12、18 和 24 个月测量的参数与新鲜供应的 FDP 剂量进行了比较。
与所有野外储存组相比,INR、PT、PTT、pH 值、纤维蛋白原和因子 VIII 比较时,发现新鲜供应的 FDP 发生了变化。因子 XI 在过期后 12、18 和 24 个月的样本中、因子 V 和 R 在过期后 24 个月的样本中、MA 在过期后 12、24 个月的样本中以及蛋白 C 在过期后 18 个月的样本中也出现了显著变化。残余水分从新鲜供应的 FDP 的 0.90%增加到过期后 24 个月的 FDP 的 1.35%;所有 p < 0.05。无菌性分析未发现生长。
尽管野外储存条件不受控制,但研究结果表明,即使超过保质期,FDP 单位在不受控制的条件下的安全性和有效性也只有轻微影响。这些信息允许考虑延长保质期。