title: Evaluation of the hemostatic potential including thrombin generation of three different therapeutic pathogen-reduced plasmas.
abstract: OBJECTIVE
  Several pathogen inactivation methods currently applied to therapeutic plasma may result in products with different hemostatic properties. This study aims at evaluating and comparing the hemostatic potential of different therapeutic plasma preparations currently available in France.
  
  
  METHODS
  We studied three types of pathogen-reduced plasma for transfusion (MB/light, Amotosalen/UVA, industrial S/D plasma). Quarantine, non-pathogen-reduced plasma, was used as a control. This study compared more specifically the content in FVIII, fibrinogen (clottable and antigen assays) and ADAMTS-13 and evaluated the intrinsic hemostatic properties using a thrombin generation test [Calibrated Automated Thrombogram (CAT)] at high and low concentrations of tissue factor to assess the maximum quantity of thrombin generated or the contribution of FVIII and FIX in the amplification phase of thrombin generation, respectively.
  
  
  RESULTS
  The median FVIII concentration was >70 IU/dl for each preparation. Endogenous thrombin potential values were significantly different among the methods of plasma preparation (P<0·001) but were all in the range of the values measured in donors' plasma. Control by the thrombomodulin-activated protein C system was preserved in all preparations (>50% inhibition of endogenous thrombin potential). Fibrinogen concentrations were all within normal range but fibrinogen levels were lower in the plasmas treated with photochemical methods. ADAMTS-13 levels were preserved.
  
  
  CONCLUSIONS
  The hemostatic potential appears well preserved in all therapeutic plasmas tested but there are some differences between preparations, the clinical relevance of which remains to be elucidated.
authors.affiliation: EFS Lorraine Champagne, Vandoeuvre les Nancy, France. m.toussaint-hacquard@chu-nancy.fr
authors.forename: M
authors.initials: M
authors.lastname: Hacquard
authors.forename: T
authors.initials: T
authors.lastname: Lecompte
authors.forename: B
authors.initials: B
authors.lastname: Belcour
authors.forename: C
authors.initials: C
authors.lastname: Geschier
authors.forename: C
authors.initials: C
authors.lastname: Jacquot
authors.forename: E
authors.initials: E
authors.lastname: Jacquot
authors.forename: T
authors.initials: T
authors.lastname: Schneider
mesh_terms: D051722:ADAM Proteins / Q000097:blood; D000071120:ADAMTS13 Protein; D005169:Factor VIII / Q000032:analysis; D005340:Fibrinogen / Q000032:analysis; D005602:France; D006487:Hemostasis; D006801:Humans; D010949:Plasma / Q000737:chemistry / Q000382:microbiology; D013917:Thrombin / Q000096:biosynthesis*
chemical_list: D005169:Factor VIII; D005340:Fibrinogen; D013917:Thrombin; D051722:ADAM Proteins; D000071120:ADAMTS13 Protein; C099604:ADAMTS13 protein, human