title: Quarantine versus pathogen-reduced plasma-coagulation factor content and rotational thromboelastometry coagulation.
abstract: Different types of fresh-frozen plasma (FFP) exist, and the concentrations of plasma proteins vary between individuals and blood groups. Furthermore, processing may also influence the content. Quarantine-stored plasma (qFFP) and plasma that was pathogen-reduced using blood-safety (Intercept) technology (piFFP) were analyzed regarding procoagulant and anticoagulant hemostasis proteins, including endogenous thrombin (thrombin-generation) potential (ETP).
  
  
  
  Thirty-five samples of each type of FFP were analyzed using only male Blood Group O donors. FFP units were stored frozen for comparable periods of time before plasma protein content was assessed. Once the units were thawed, all tests were completed within 4 hours. The results are presented as means ± standard deviations or as median (minimum; maximum) and were compared using independent-sample t tests (significance, p < 0.01).
  
  
  
  Significantly higher concentrations of adintegrin-like and metalloprotease with thrombospondin type-13 motifs (ADAMTS13), fibrinogen, Factor (F)V, FVIII, FXIII, protein S, protein S activity, antithrombin, microvesicle (<900 nm), and α2 antiplasmin were observed in qFFP. The variability of factors was significantly lower in piFFP. Tissue factor (TF) at 1 picomolar (pM) exhibited significantly longer lag time, a lower peak, lower ETP, and a lower velocity index in qFFP compared with piFFP. In TF at 5 pM, significant differences in lag time (longer in qFFP), velocity index (lower in qFFP), and peak (lower in qFFP) were observed. Rotational thromboelastometry revealed a significantly longer (p = 0.002) clot-formation time with intrinsic thromboelastometry for piFFP and a significantly shorter clotting time (p = 0.004) with thromboelastometry fibrinogen testing for piFFP.
  
  
  
  Pathogen reduction reduces procoagulant and anticoagulant coagulation factors as well as variability. A thrombin-generation assay showed no reduced ETP and no supraphysiological thrombin generation. None of the FFP preparations is likely to be effective for treating fibrinogen deficiency.
authors.affiliation: Institute of Anesthesiology, University and University Hospital Zurich, Zurich, Switzerland.
authors.forename: Oliver M
authors.initials: OM
authors.lastname: Theusinger
authors.affiliation: Regional Blood Transfusion Service, Zurich Swiss Red Cross, Zurich, Switzerland.
authors.forename: David
authors.initials: D
authors.lastname: Goslings
authors.affiliation: Division of Hematology, University and University Hospital Zurich, Zurich, Switzerland.
authors.forename: Jan-Dirk
authors.initials: JD
authors.lastname: Studt
authors.affiliation: Division of Hematology, University and University Hospital Zurich, Zurich, Switzerland.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Brand-Staufer
authors.affiliation: Department of Biostatistics, Epidemiology, Biostatistics, and Prevention Institute, University of Zurich, Zurich, Switzerland.
authors.forename: Burkhardt
authors.initials: B
authors.lastname: Seifert
authors.affiliation: Institute of Anesthesiology, University and University Hospital Zurich, Zurich, Switzerland.
authors.forename: Donat R
authors.initials: DR
authors.lastname: Spahn
authors.affiliation: Regional Blood Transfusion Service, Zurich Swiss Red Cross, Zurich, Switzerland.
authors.forename: Beat M
authors.initials: BM
authors.lastname: Frey
mesh_terms: D001793:Blood Preservation; D015925:Cryopreservation; D004203:Disinfection; D005169:Factor VIII / Q000737:chemistry / Q000378:metabolism*; D005340:Fibrinogen / Q000737:chemistry / Q000378:metabolism*; D006801:Humans; D008297:Male; D010949:Plasma / Q000737:chemistry / Q000378:metabolism*; D011790:Quarantine; D013916:Thrombelastography
chemical_list: C026912:cryoprecipitate coagulum; D005169:Factor VIII; D005340:Fibrinogen