Quality Assessment and Clinical Utility of Plasma Obtained Via Apheresis vs That Obtained from Whole Blood.

OBJECTIVE

We studied the impact of storage of thawed plasma (TP) on the in vitro coagulation quality and posttransfusion outcomes of apheresis plasma (AP) vs whole blood plasma (WBP).

METHODS

One hundred units of each product were analyzed. In vitro assays were performed on TP on day 0, day 2, and after refreezing, evaluating international normalized ratio (INR), activated partial thromboplastin time (aPTT), fibrinogen, and factors V and VIII. Transfusion of TP on day 2 was studied in 70 patients with liver cirrhosis and 25 patients with thrombotic thrombocytopenic purpura (TTP).

RESULTS

Refrozen specimens from both products showed a significant decline of all values, although AP had a considerably greater coagulation profile (P < .05).On day 0 and day 2, we observed significant decreases in coagulation values (except fibrinogen) with WBP, compared with AP (P < .05). The WBP, however, provided similar INR for patients with liver cirrhosis and TTP, as compared with AP. The AP resulted in a significant correction of aPTT following plasma exchange in TTP (P < .05).

CONCLUSION

AP demonstrated considerably greater factor activity. This would be beneficial when manufacturing clotting factor concentrates. Large scale clinical trials are needed to further address the hemostatic outcomes of both products in massively transfused patients.