scholarly journals Coagulation profile of human COVID-19 convalescent plasma

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Allan M. Klompas ◽  
Noud van Helmond ◽  
Justin E. Juskewitch ◽  
Rajiv K. Pruthi ◽  
Matthew A. Sexton ◽  
...  
Keyword(s):  
Coagulation Factor ◽  
Protein S ◽  
Coagulation Factors ◽  
Fresh Frozen Plasma ◽  
Thrombin Time ◽  
Fresh Frozen ◽  
Von Willebrand ◽  
Willebrand Factor ◽  
Plasmin Inhibitor ◽  
Frozen Plasma

AbstractConvalescent plasma is used to treat COVID-19. There are theoretical concerns about the impact of pro-coagulant factors in convalescent plasma on the coagulation cascade particularly among patients with severe COVID-19. The aim of this study was to evaluate the coagulation profile of COVID-19 convalescent plasma. Clotting times and coagulation factor assays were compared between fresh frozen plasma, COVID-19 convalescent plasma, and pathogen-reduced COVID-19 convalescent plasma. Measurements included prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen, D-dimer, von Willebrand factor activity, von Willebrand factor antigen, coagulation factors II, V, VII–XII, protein S activity, protein C antigen, and alpha-2 plasmin inhibitor. Clotting times and coagulation factor assays were not different between COVID-19 convalescent plasma and fresh frozen plasma, except for protein C antigen. When compared to fresh frozen plasma and regular convalescent plasma, pathogen reduction treatment increased activated partial thromboplastin time and thrombin time, while reducing fibrinogen, coagulation factor II, V, VIII, IX, X, XI, XII, protein S activity, and alpha-2 plasmin inhibitor. The coagulation profiles of human COVID-19 convalescent plasma and standard fresh frozen plasma are not different. Pathogen reduced COVID-19 convalescent plasma is associated with reduction of coagulation factors and a slight prolongation of coagulation times, as anticipated. A key limitation of the study is that the COVID-19 disease course of the convalesced donors was not characterized.

scholarly journals Effects of fresh-frozen plasma and its cryosupernatant fraction on von Willebrand factor multimeric forms in chronic relapsing thrombotic thrombocytopenic purpura

Blood ◽  
1985 ◽  
Vol 65 (5) ◽  
pp. 1232-1236 ◽  
Author(s):  
JL Moake ◽  
JJ Byrnes ◽  
JH Troll ◽  
CK Rudy ◽  
SL Hong ◽  
...  
Keyword(s):  
Plasma Exchange ◽  
Fresh Frozen Plasma ◽  
Plasma Samples ◽  
Fresh Frozen ◽  
Normal Human ◽  
Von Willebrand ◽  
Willebrand Factor ◽  
Frozen Plasma

Abstract Remission plasma samples of some patients with chronic relapsing thrombotic thrombocytopenic purpura (TTP) contain unusually large von Willebrand factor (vWF) multimers similar to those produced by normal human endothelial cells in culture. The infusion of the cryosupernatant fraction of normal plasma is as effective as normal fresh-frozen plasma (FFP) in the treatment or prevention of TTP episodes in patients with the chronic relapsing form of TTP. Three patients with chronic relapsing TTP during remission have unusually large vWF multimers present in their plasma. Two of the patients were transfused once with FFP, one of the two received cryosupernatant on three occasions, and the third patient was studied before and immediately after plasma exchange. Unusually large vWF multimers decreased or disappeared from patient plasma samples within 1/2 to 1 1/2 hours following the transfusion of FFP (on two occasions) or cryosupernatant (on two of three occasions), and immediately after plasma exchange (on one occasion). The patient who received cryosupernatant was studied serially after the infusions. Unusually large vWF multimers returned to her plasma within ten to 24 hours and persisted thereafter. Unusually large vWF multimers did not disappear from patient remission plasma samples, or from the culture medium removed from normal human endothelial cells, when these fluids were incubated in vitro with either normal FFP or cryosupernatant. We conclude that an activity in FFP, and its cryosupernatant fraction, promoted the rapid in vivo disappearance of unusually large vWF multimers from the plasma of two patients with chronic relapsing TTP in remission, and plasma exchange reversed the abnormality in a third patient who was in partial remission. Neither FFP nor cryosupernatant directly converted unusually large multimers to smaller vWF forms in vitro in the fluid phase. These results indicate that an activity in the cryosupernatant fraction of normal plasma is involved in vivo in controlling the metabolism of unusually large vWF multimers, and that this process is defective in some chronic relapsing TTP patients.

scholarly journals Effects of fresh-frozen plasma and its cryosupernatant fraction on von Willebrand factor multimeric forms in chronic relapsing thrombotic thrombocytopenic purpura

Blood ◽  
1985 ◽  
Vol 65 (5) ◽  
pp. 1232-1236 ◽  
Author(s):  
JL Moake ◽  
JJ Byrnes ◽  
JH Troll ◽  
CK Rudy ◽  
SL Hong ◽  
...  
Keyword(s):  
Plasma Exchange ◽  
Fresh Frozen Plasma ◽  
Plasma Samples ◽  
Fresh Frozen ◽  
Normal Human ◽  
Von Willebrand ◽  
Willebrand Factor ◽  
Frozen Plasma

Remission plasma samples of some patients with chronic relapsing thrombotic thrombocytopenic purpura (TTP) contain unusually large von Willebrand factor (vWF) multimers similar to those produced by normal human endothelial cells in culture. The infusion of the cryosupernatant fraction of normal plasma is as effective as normal fresh-frozen plasma (FFP) in the treatment or prevention of TTP episodes in patients with the chronic relapsing form of TTP. Three patients with chronic relapsing TTP during remission have unusually large vWF multimers present in their plasma. Two of the patients were transfused once with FFP, one of the two received cryosupernatant on three occasions, and the third patient was studied before and immediately after plasma exchange. Unusually large vWF multimers decreased or disappeared from patient plasma samples within 1/2 to 1 1/2 hours following the transfusion of FFP (on two occasions) or cryosupernatant (on two of three occasions), and immediately after plasma exchange (on one occasion). The patient who received cryosupernatant was studied serially after the infusions. Unusually large vWF multimers returned to her plasma within ten to 24 hours and persisted thereafter. Unusually large vWF multimers did not disappear from patient remission plasma samples, or from the culture medium removed from normal human endothelial cells, when these fluids were incubated in vitro with either normal FFP or cryosupernatant. We conclude that an activity in FFP, and its cryosupernatant fraction, promoted the rapid in vivo disappearance of unusually large vWF multimers from the plasma of two patients with chronic relapsing TTP in remission, and plasma exchange reversed the abnormality in a third patient who was in partial remission. Neither FFP nor cryosupernatant directly converted unusually large multimers to smaller vWF forms in vitro in the fluid phase. These results indicate that an activity in the cryosupernatant fraction of normal plasma is involved in vivo in controlling the metabolism of unusually large vWF multimers, and that this process is defective in some chronic relapsing TTP patients.

Management of Excessive Anticoagulant Effect Due to Vitamin K Antagonists

Hematology ◽  
2008 ◽  
Vol 2008 (1) ◽  
pp. 266-270 ◽  
Author(s):  
Francesco Dentali ◽  
Mark A. Crowther
Keyword(s):  
Vitamin K ◽  
Vitamin K Antagonists ◽  
Coagulation Factor ◽  
Reference Interval ◽  
Coagulation Factors ◽  
Fresh Frozen Plasma ◽  
Treatment Modalities ◽  
Oral Vitamin ◽  
Fresh Frozen ◽  
Frozen Plasma

Abstract Unexpectedly elevated INR values are commonly encountered in clinical practice. In the absence of bleeding, such values may be treated with either simple warfarin withdrawal or the administration of low doses of oral vitamin K. Oral vitamin K will more rapidly return the INR to the therapeutic reference interval; however, its impact on bleeding is unknown. If the INR is in excess of 10, most experts would recommend the administration of vitamin K and, in the case of active bleeding, additional administration of coagulation factors either in the form of fresh frozen plasma (FFP) or prothrombin complex concentrates (PCC). Coagulation factor replacement is required given the need to urgently correct the INR; however, vitamin K should not be forgotten since it is required to antagonize the effect of warfarin, preventing “rebound” anticoagulation after transfused coagulation factors are consumed. This paper will review the evidence supporting various treatment modalities and will provide suggestions for treatment. Future advances in this area will likely focus on evaluations of the relative merits of FFP and PCCs.

TYPE IIB VON WILLEBRAND DISEASE WITH CHRONIC THROMBOCYTOPENIA : BENEFICIAL EFFECT OF CRYOPRECIPITATE SUPERNATANT INFUSION ON PLATELET COUNT AND BLEEDING

1987 ◽  
Author(s):  
A Derlon ◽  
A Le Querrec ◽  
E Lebrun ◽  
G Tobelem ◽  
M Thomas
Keyword(s):  
Platelet Count ◽  
Von Willebrand Factor ◽  
Fresh Frozen Plasma ◽  
Von Willebrand Disease ◽  
Severe Thrombocytopenia ◽  
Plasma Infusion ◽  
Fresh Frozen ◽  
Von Willebrand ◽  
Willebrand Factor ◽  
Frozen Plasma

As we previously described, plasma infusion increased platelet count (PC) in four patients with IIB von Willebrand disease with severe thrombocytopenia. In a sixty years old patient in the same family, with chronic thrombocytopenia (PC = 30 000/ml) associated to an absence of large von Willebrand Factor multi-mers (vWF) in plasma, we successfully treated :1° A gastrointestinal bleeding episode with fresh frozen plasma infusion (15ml/Kg/day).2° Three months later a severe epistaxis with cryoprecipi-tate supernatant (15ml/Kg/day).During these bleeding episodes, the efficiency of these two treatments on the PC could be ascertained according to the following figureWe observed after ten days of these two treatments the following biological effects : a normalisation of vWF cross immunoelectrophoresis, of ristocetin induced normal platelet aggregation by patient's plasma, and of patient's plasma vWF binding to control platelets.In conclusion a factor appears to be present in both fresh frozen plasma and cryoprecipitate supernatant which prevents the abnormal binding of von Willebrand Factor (in this IIB von Willebrand disease) to the patient's platelets.

EPTACOG ALFA. APPLICATION EXPERIENCE

2017 ◽  
Author(s):  
И. Нехаев ◽  
А. Приходченко ◽  
С. Ломидзе ◽  
А. Сытов
Keyword(s):  
Intensive Care Unit ◽  
Malignant Tumors ◽  
Coagulation Factors ◽  
Fresh Frozen Plasma ◽  
Massive Bleeding ◽  
Threshold Concentration ◽  
Damage Area ◽  
Fresh Frozen ◽  
Hemostatic Therapy ◽  
Frozen Plasma

Введение. Несмотря на переливания свежезамороженной плазмы и тромбоцитов, часто не удается достигнуть нужной «пороговой» концентрации факторов свертывания при массивных кровотечениях. При введении рекомбинантного активированного VII фактора (rFVIIa, эптаког альфа) этот процесс может быть ускорен, происходит «тромбиновый взрыв», который обеспечивает образование стабильной фибриновой пробки. Цель исследования: оценка эффективности и безопасности применения rVIIа в онкохирургии при коагулопатических кровотечениях. Материалы и методы. Обследовано 38 пациентов, оперированных по поводу злокачественных новообразований различной локализации, находившихся на лечении в отделении реанимации и интенсивной терапии № 1 в течение 2014 года. Результаты. Клиническая эффективность rFVIIа составила 94,7% при неэффективности стандартной гемостатической терапии и исчерпанных возможностях хирургического гемостаза при коагулопатических кровотечениях у онкохирургических больных. Заключение. rFVIIа обладает селективным действием (действует в зоне повреждения), что подтверждают данные коагулограммы и тромбоэлаcтометрии. rFVIIа не утяжеляет состояния больных. Introduction. Despite the transfusion of fresh frozen plasma and platelets it is often not possible to achieve the desired «threshold» concentration of coagulation factors in case of acute massive bleeding. Administration of recombinant activated VII factor (rFVIIa, eptacog alfa) can accelerates this process; «thrombin burst» occurs that provides the formation of a stable fi brin plug. Aim: to assess the effectiveness and safety of rVIIa usage in oncosurgery at coagulopathic bleedings. Materials and methods. In intensive care unit during 2014 we examined 38 patients with malignant tumors of various locations after surgery. Results. Clinical efficacy of rFVIIa was 94,7% with ineffectiveness of standard hemostatic therapy and exhausted possibilities of surgical hemostasis with coagulopathic bleedings in oncosurgical patients. Conclusion. rFVIIa has a targeted action (acts in damage area); coagulogram and thromboelometry data prove its action. rFVII does not make patients worse.

Sign in / Sign up

Export Citation Format

Share Document