Abstract 18704: Composition Dependence of the Clot Stabilizing Potential of Transfusion Plasmas
Introduction: Each transfusion unit of fresh frozen plasma (FFP) is produced from an individual blood donor and can vary two to threefold in the concentrations of the procoagulant, anticoagulant, profibrinolytic and antifibrinolytic factors. The extent to which this variation may practically impact the efficacy of individual units in managing hemorrhage remains unclear.
Hypothesis: The relative ability of FFP units to support clot formation and resist lysis will correlate with the concentrations of a subset of coagulation/fibrinolytic factors.
Methods: Plasma units (N=10) were obtained from the University of Vermont Medical Center Blood Bank. Concentrations of factors II, V, VII, VIII, IX, X, XI, XII, antithrombin, protein C, TFPI, plasminogen, TAFI and PAI-1 were measured in each plasma. Clot formation and lysis were monitored by viscoelastometry. Recalcified plasmas were subjected to 4 assay conditions: a 5 pM tissue factor stimulus ± tissue plasminogen activator (2 nM, 4 nM, 8 nM). Parameters (clot time (CT), α (angle), maximum clot firmness (MCF) and time to 50% lysis (LY50)) were extracted from each progress curve and correlated with measured factor levels.
Results: Comparing the FFPs, the difference between high and low values for each parameter ranged between 2 and 4 fold in each of the 4 assay conditions. Larger LY50 values, suggesting improved resistance to clot lysis, appeared insensitive to any single factor, showing only weak correlations with increasing FVIII and fibrinogen levels (R2 ~ 0.25) and TAFI (R2 = 0.36). Stronger correlations with single factors were observed with coagulant parameters: increasing fibrinogen with MCF (R2=0.72); and decreasing FVIII with CT (R2=0.72) and α (R2=0.64).
Conclusions: Differences in hemostatic potential between FFP units suggest that pre-screening of units could be useful. Factor analysis alone did not identify targets that could be used to eliminate units with less functional capacity.
Author Disclosures: T. Orfeo: None. M. Gissel: None. M. Bravo: None. M. Fung: None. K. Brummel-Ziedins: None.
- © 2016 by American Heart Association, Inc.