title: Thawed solvent/detergent-treated plasma: too precious to be wasted after 6 hours?
abstract: BACKGROUND
  Coagulopathy associated with trauma and bleeding requires early administration of haemostatic agents. Solvent/detergent-treated plasma (S/D-plasma) requires thawing and its availability for clinical use is, therefore, delayed. The long-term stability of clotting factors in thawed S/D-plasma has not been thoroughly investigated. The purpose of this study was to evaluate stability of clotting factors and inhibitors in thawed S/D-plasma stored at 4 °C for 6 days.
  
  
  METHODS
  Clotting factor levels and bacterial contamination were investigated using 20 units of S/D-plasma. Fibrinogen, factor (F) II, FV, FVII, FVIII, FIX, FX, FXI, FXII, FXIII, antithrombin, von Willebrand antigen (VWF-Ag), plasmin inhibitor, protein C and free protein S were analysed over time.
  
  
  RESULTS
  After 6 days of storage the results were as follows: fibrinogen 270 mg/dL (-10 mg/dL, p=0.0204), FII 75% (-5%, p<0.0001), FV 88% (-14%, p<0.0001), FVII 81% (-24%, p<0.0001), FVIII 70% (-16%, p<0.0001), FIX 96% (-8, p<0.0001), FX 92% (-1%, p<0.0001), FXI 119% (-4%, p=0.3666), FXII 94% (-2%, p=0.3602), FXIII 89% (-1%, p 0.0019), free protein S 76% (-4%, p<0.0001), protein C 96% (+1%, p=0.0371), antithrombin 92% (-3%, p<0.0001), plasmin inhibitor 29% (-4%, p<0.0299), VWF-Ag 137% (+2%, p=0.2205). FVII and FVIII showed a critical drop of more than 20% or approached the lower quality assurance threshold after storage for more than 24 hours. No S/D-plasma showed bacterial contamination.
  
  
  CONCLUSIONS
  All clotting factors in thawed S/D plasma remained stable for up to 24 hours when stored at 4 °C. Storage of thawed S/D plasma may improve the availability of this product in emergency situations.
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum and Campus Charité Mitte, Berlin, Germany. mareike.keller@charite.de
authors.forename: Mareike Kristina
authors.initials: MK
authors.lastname: Keller
authors.forename: Axel
authors.initials: A
authors.lastname: Pruss
authors.forename: Michael
authors.initials: M
authors.lastname: Sander
authors.forename: Claudia
authors.initials: C
authors.lastname: Spies
authors.forename: Helge
authors.initials: H
authors.lastname: Schoenfeld
authors.forename: Michael
authors.initials: M
authors.lastname: Schuster
authors.forename: Kristian
authors.initials: K
authors.lastname: Meinck
authors.forename: Klaus-Dieter
authors.initials: KD
authors.lastname: Wernecke
authors.forename: Christian
authors.initials: C
authors.lastname: Von Heymann
mesh_terms: D001419:Bacteria / Q000254:growth & development / Q000302:isolation & purification; D001779:Blood Coagulation Factors / Q000032:analysis / Q000737:chemistry / Q000276:immunology; D016913:Blood Component Transfusion / Q000379:methods; D001793:Blood Preservation; D003902:Detergents; D006801:Humans; D010949:Plasma / Q000737:chemistry / Q000378:metabolism / Q000382:microbiology; D012997:Solvents; D013997:Time Factors
chemical_list: D001779:Blood Coagulation Factors; D003902:Detergents; D012997:Solvents