Storage of thawed plasma for a liquid plasma bank: impact of temperature and methylene blue pathogen inactivation
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BACKGROUND: Rapid transfusion of fresh‐frozen plasma (FFP) is desired for treating coagulopathies, but thawing and issuing of FFP takes more than 40 minutes. Liquid storage of plasma is a potential solution but uncertainties exist regarding clotting factor stability. We assessed different storage conditions of thawed FFP and plasma treated by methylene blue plus light (MB/light) for pathogen inactivation.STUDY DESIGN AND METHODS: Fifty thawed apheresis plasma samples (approx. 750 mL) were divided into three subunits and either stored for 7 days at 4°C, at room temperature (RT), and at 4°C after MB/light treatment. Clotting factor activities (Factor [F] II, FV, FVII through FXIII, fibrinogen, antithrombin, von Willebrand factor antigen, Protein C and S) were assessed after thawing and on Days 3, 5, and 7. Changes were classified as “minor” (activities within the reference range) and “major” (activities outside the reference range).RESULTS: FFP storage at 4°C revealed major changes for FVIII (median [range], 56% [33%‐114%]) and Protein S (51% [20%‐88%]). Changes were more pronounced when plasma was stored at RT (FVIII, 59% [37%‐123%]; FVII, 69% [42%‐125%]; Protein S, 20% [10%‐35%]). MB/light treatment of thawed FFP resulted in minor changes. However, further storage for 7 days at 4°C revealed major decreases for FVIII (47% [12%‐91%]) and Protein S (49% [18%‐95%]) and increases for FVII (150% [48%‐285%]) and FX (126% [62%‐206%]).CONCLUSION: Storage of liquid plasma at 4°C for 7 days is feasible for FFP as is MB/light treatment of thawed plasma. In contrast, storage of thawed plasma for 7 days at RT or after MB/light treatment at 4°C affects clotting factor stability substantially and is not recommended.
