title: A model comparing how rapidly transfusion of solvent detergent plasma restores clotting factors versus infusion of albumin-saline.
abstract: BACKGROUND
  A recent randomized controlled trial demonstrated the bioequivalence between universally applicable and AB0 compatible transfusion plasma in healthy volunteers. There was a limited change in coagulation factor levels and inhibitors before and after plasmapheresis and subsequent plasma transfusion. The aim of this extension trial was to investigate the true capacity of these plasma products to restore baseline levels of coagulation factors and inhibitors after plasma depletion in comparison to haemodilution induced by infusion of albumin solution.
  
  
  METHODS
  Fourteen healthy subjects, who completed both plasma transfusion periods, underwent an additional plasmapheresis (600 mL) followed by an infusion of 1200 mL albumin (3.125%) in a third period.
  
  
  RESULTS
  The fibrinogen levels, as well as other clotting factors (FII, FV, FVII and FXI), decreased by 10% after plasmapheresis, and subsequent infusion of albumin solution further aggravated this drop in clotting factors to approximately 20-25%. The clotting factors with a long half-life were not even restored 24 hours after infusion of albumin solution, whereas those with a short half-life were replenished by endogenous synthesis within 24 hours. In contrast, transfusion of either plasma product rapidly restored all clotting parameters and inhibitors (protein S and plasmin inhibitor) immediately after transfusion.
  
  
  CONCLUSIONS
  This study demonstrates that albumin solution induces an enhanced dilution of clotting factors and inhibitors, whereas both plasma products quickly compensated for the experimental loss of these plasma proteins.
authors: Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria; Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.
authors: Petra
authors: P
authors: Jilma-Stohlawetz
authors: Clinical Research and Development Department, Octapharma Pharmazeutika Produktionsges.m.b.H, Vienna, Austria.
authors: Friedrich W
authors: FW
authors: Kursten
authors: Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria.
authors: Michaela
authors: M
authors: Horvath
authors: Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria.
authors: Gerda
authors: G
authors: Leitner
authors: Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria.
authors: Jana
authors: J
authors: List
authors: Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.
authors: Jana
authors: J
authors: Marcek
authors: Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.
authors: Peter
authors: P
authors: Quehenberger
authors: Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.
authors: Michael
authors: M
authors: Schwameis
authors: Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.
authors: Johann
authors: J
authors: Bartko
authors: Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria. Electronic address: Bernd.Jilma@meduniwien.ac.at.
authors: Bernd
authors: B
authors: Jilma
mesh_terms: D000328:Adult; D001779:Blood Coagulation Factors / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D010949:Plasma; D010951:Plasma Exchange; D010956:Plasmapheresis; D012709:Serum Albumin / Q000008:administration & dosage*; D012965:Sodium Chloride / Q000008:administration & dosage*
chemical_list: D001779:Blood Coagulation Factors; D012709:Serum Albumin; D012965:Sodium Chloride
keywords: Clinical trial; Fresh frozen plasma; Haemostasis