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Effect of storage of plasma in the presence of red blood cells and platelets: re‐evaluating the shelf life of whole blood
Author(s) -
Huish Sian,
Green Laura,
Curnow Elinor,
Wiltshire Michael,
Cardigan Rebecca
Publication year - 2019
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/trf.15549
Subject(s) - platelet , whole blood , fresh frozen plasma , clotting time , saline , clotting factor , andrology , chemistry , fibrinogen , red blood cell , coagulation , medicine , white blood cell , mannitol , endocrinology , biochemistry
BACKGROUND There is renewed interest in administering whole blood (WB) for the resuscitation of patients with bleeding trauma. The shelf life of WB was established decades ago based on the viability of red blood cells. However, plasma quality during WB storage is not established. STUDY DESIGN AND METHODS White blood cell– and platelet‐reduced WB (WB–PLT) was prepared using standard processes and compared to WB processed using a platelet‐sparing WBC reduction (WB + PLT) filter. WB (± PLT) was held at 2 to 6°C for 35 days alongside control units of red blood cells (RBCs) in saline, adenine, glucose, and mannitol and liquid plasma. A series of assays explored the coagulation potential and RBC quality. RESULTS While fibrinogen and α2‐antiplasmin remained unaffected by storage, other factors varied between components or over time at 2 to 6°C. At 14 days factor V, factor VII, α 2 ‐antiplasmin and free protein S antigen remained on average greater than 0.50 IU/mL or 50%, as appropriate, in WB ± PLT. Factor VIII was on average 0.49 IU/mL in WB+PLT, and 0.56 IU/mL for WB–PLT. Free protein S activity decreased significantly in all arms but remained on average greater than 40% at Day 14. Contact activation was not demonstrated before Day 14. Thrombin generation in plasma remained relatively stable to Day 35 in all arms. CONCLUSIONS Clotting factor activity remained at or above a mean of 0.5 IU/mL, or 50%, at Day 14 for factor V, factor VII, factor VIII, free protein S, fibrinogen, and α2‐antiplasmin in all arms. Further data on platelet function in WB+PLT is needed to inform its shelf life.