Premium
Coagulation factor levels in cryosupernatant prepared from plasma treated with amotosalen hydrochloride (S‐59) and ultraviolet A light
Author(s) -
Yarranton Helen,
Lawrie Andrew S.,
Mackie Ian J.,
Pinkoski Linda,
Corash Laurence,
Machin Samuel J.
Publication year - 2005
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.1537-2995.2005.00551.x
Subject(s) - fresh frozen plasma , hemostasis , thrombotic thrombocytopenic purpura , antithrombin , chemistry , von willebrand factor , coagulation , blood product , surgery , medicine , platelet , gastroenterology , heparin
BACKGROUND: The standard treatment for thrombotic thrombocytopenic purpura (TTP) is plasma exchange with fresh‐frozen plasma (FFP). Exposure to large volumes of FFP increases the risk of transfusion‐transmitted infections. Cryosupernatant (CSP) offers a theoretical advantage over FFP, because it lacks the large von Willebrand factor (VWF) forms implicated in the pathogenesis of TTP. This study compared the hemostatic variables of CSP prepared from FFP treated with a photochemical pathogen inactivation process to CSP prepared from conventional FFP. STUDY DESIGN AND METHODS: Forty CSP units were prepared from North American blood group A donor FFP. Twenty‐one of the FFP units were individually treated with amotosalen hydrochloride (S‐59) and ultraviolet A light (test, photochemically treated FFP), and 19 units were not treated (control, FFP). RESULTS: Hemostatic variables of test and control CSP were similar and within reported ranges for conventional FFP with the exception of those properties depleted in CSP. VWF‐cleaving protease activity (VWF:CP) and protein S (PS) levels (total and free antigen and activity) were within the conventional FFP reference range for test and control CSP. There were statistical differences between test and control CSP for α 2 ‐antiplasmin, antithrombin, protein C, and VWF:CP on a per‐volume basis, but all levels were within the reference range for FFP, and the differences were not significant when expressed per gram of CSP protein. CONCLUSION: S‐59–treated CSP retained adequate levels of critical plasma proteins for plasma exchange therapy in acute TTP. The data indicate good preservation of hemostasis control proteins such as PS, α 2 ‐antiplasmin, and VWF:CP activity (ADAMTS13).