title: Occurrence of cold activation of transfusion plasma during storage at +4 degrees C.
abstract: OBJECTIVE
  The storage of transfusion plasma at +4 degrees C sometimes leads to the activation of several proteolytic systems. In this study the frequency of cold activation was investigated, as well as whether cold activation of plasma is an individually recurrent property of the donor.
  
  
  METHODS
  Plasma units prepared from whole blood obtained from 100 male donors were stored at +2 degrees to +5 degrees C, in bags for 28 days and in cryotubes for up to 42 days. Samples from plasma units, collected by apheresis from 100 male donors, were stored in cryotubes for up to 42 days. Cold activation was measured weekly as kallikrein-like activity of plasma. Samples from repeat apheresis plasma units from 32 donors were measured 12-20 months later. The effects of storage on the contact, coagulation and fibrinolytic systems were determined.
  
  
  RESULTS
  The cumulative frequency of cold-activated plasma units stored in bags was 5% on day 7 and 18% on day 28. After 42 days in cryotubes, 49% of the plasma units were cold activated. Large intraindividual differences in the onset-day of cold activation were observed in plasma samples of some donors. During cold activation, an increase in kallikrein-like activity was accompanied by a decrease in C1 esterase inhibitor activity and an increase in the concentrations of activated factor VII and fibrinopeptide A. The functional plasminogen level was unchanged, while a minor decrease in plasmin inhibitor activity was combined with a corresponding increase in the concentration of plasmin-plasmin inhibitor complex.
  
  
  CONCLUSIONS
  The cumulative frequency of cold-activated plasma units increased in a time-dependent manner during storage at +2 degrees to +5 degrees C for 42 days. The intraindividual onset-day of cold activation varied widely between plasma samples of some donors. Cold activation was associated with a high degree of activation of the contact and coagulation systems. The fibrinolytic system was scarcely affected.
authors.affiliation: Department of Surgical Sciences, Blood Coagulation Research, Karolinska Institutet and Karolinska University Hospital, Solna, Sweden. Anna-Maija.Suontaka@kirurgi.ki.se
authors.forename: A M
authors.initials: AM
authors.lastname: Suontaka
authors.forename: A
authors.initials: A
authors.lastname: Silveira
authors.forename: T
authors.initials: T
authors.lastname: Söderström
authors.forename: M
authors.initials: M
authors.lastname: Blombäck
mesh_terms: D001779:Blood Coagulation Factors / Q000737:chemistry; D001781:Blood Component Removal / Q000379:methods; D001792:Blood Platelets; D001793:Blood Preservation / Q000379:methods*; D001803:Blood Transfusion / Q000379:methods*; D003080:Cold Temperature; D003173:Complement C1s / Q000378:metabolism; D004791:Enzyme Inhibitors / Q000494:pharmacology; D015942:Factor VIIa / Q000737:chemistry; D005341:Fibrinolysin / Q000037:antagonists & inhibitors / Q000737:chemistry; D005344:Fibrinopeptide A / Q000737:chemistry; D006801:Humans; D010949:Plasma; D013048:Specimen Handling; D013696:Temperature; D013997:Time Factors
chemical_list: D001779:Blood Coagulation Factors; D004791:Enzyme Inhibitors; D005344:Fibrinopeptide A; D015942:Factor VIIa; D003173:Complement C1s; D005341:Fibrinolysin