Assistant Professor of Laboratory Medicine Yale University School of Medicine Fairfield, Connecticut, United States
Background/Case Studies: Liquid plasma (LQP) stands out as an alternative to thawed plasma (TP) with longer shelf life and similar volume in cases requiring emergent transfusion. Here we measure fibrinogen, Protein C, Protein S, FV, FVII and FVIII levels in both LQP and TP.
Study
Design/Methods: Coagulation factor levels were measured on the same analyzer on Days 15, 26, and 27 for LQP and Day 5 for TP using segments and/or aliquots from the bags. ANOVA and Kruskal Wallis was done to compare levels throughout the storage duration of LQP. Student’s t-test or Mann Whitney was performed depending on the the distribution of the data to compare TP on Day 5 to LQP on Day 26.
Results/Findings: Fibrinogen, Protein C, Protein S, FV and FVIII remained relatively stable from Day 15 to Day 27 in LQP. FVII showed a drop from Day 15 to Day 27. Nearly ~50% activity remained on Day 26 of LQP for all factors.
When comparing LQP26 and TP5, Student’s t-test was used for Protein S, while the Mann-Whitney test was applied for all other factors. The results indicated that fibrinogen levels (258.7 vs. 250.2, p = 0.3), Protein C activity (112.5 vs. 116.1, p = 0.2), Factor V (48.6 vs. 55.7, p = 0.2), Factor VII (69.1 vs. 103.5, p = 0.09), and Factor VIII (51.8 vs. 62.7, p = 0.4) were comparable between the two groups. However, Protein S levels were significantly lower in LQP26 compared to TP5 (31.7 vs. 58.2, p = 0.0002).
Conclusions: LQP shows adequate factor levels and is comparable to TP for use in emergency transfusions and massive transfusion protocols. Our study, along with previous research, suggests that maintaining LQP as the primary plasma product for emergency use is the most effective strategy while allowing sufficient time for FFP thawing. LQP provides both volume expansion and coagulation support while significantly reducing blood product wastage.
