Effects of Pathogen Inactivation Using Amotosalen-UVA on Coagulation Parameters in Apheresis and Whole Blood Derived Frozen Plasma in a Large Blood Bank Setting.

Abstract Continuous emergence of known or new pathogens as well as increasing complexity of pathogen testing challenge the provision of safe blood products. Pathogen inactivation using amotosalen + UVA effectively reduces a number of different pathogens including viruses, bacteria and parasites (Transfusion2006;46:1168). We determined the impact of pathogen inactivation on the coagulation activity of frozen plasma (FP) using amotosalen (150μM) and UVA (3 J/cm2) in the operational setting of a large blood bank. Plasma (650mL) was collected as single-donor apheresis plasma processed within 8h (arm A) and whole blood derived plasma pooled from three different, but ABO and Rh identical donors after an initial storage time of 8h (arm B) or after 22h (arm C) before photochemical treatment (PCT). Each 650mL unit of treated plasma was divided into 3 units of 200mL each prior to freezing at −40°C. Eight subsequent FP units (200mL) from individual collections were analyzed per arm, representing different blood groups. Samples for coagulation analysis were taken at baseline, after PCT and absorption of amotosalen (post-inactivation), and after six weeks of storage at −40°C (post-storage). Global coagulation tests (PT, aPTT), thrombin time, fibrinogen activity (Clauss) and fibrinogen antigen levels remained within normal ranges at all time points in all three arms. Similarly, activities of coagulation factors II, V, VII, IX, X, XI, XII, XIII, as well as von Willebrand factor (vWF) antigen, ristocetin cofactor, vWF-collagen binding capacity, antithrombin, protein C levels, protein S activity, plasmin-antiplasmin-complexes (PAP), plasminogen levels, and D-dimers did not show significant alterations. Median factor VIII activities were diminished compared to baseline (= 100%) in all three groups post-inactivation and post-storage, respectively (A: 84% and 80%; B: 74% and 65%; C: 84% and 93%). Significant differences in thrombin-antithrombin-complex (TAT) levels were seen between apheresis plasma (< 0.1 ng/ml) and plasma processed from whole blood after 8h (7.25 ng/ml) and 22h (57 ng/ml) of storage time prior to PCT. During pathogen inactivation, there was no increase in TAT levels ruling out that thrombin was formed through the inactivation process. In summary, pathogen inactivation of FP using amotosalen + UVA does not significantly influence coagulation parameters with the exception of FVIII. The decrease in FVIII activity might be explained in part by an additional freeze-thawing cycle included in the protocol due to technical reasons. Increased TAT levels, especially in arm C, were not reflected in decreased AT activity or an increase in other markers of coagulation activation, but indicate continuous, although moderate activation of the coagulation cascade during storage time. We conclude that the described inactivation procedure for whole blood derived and apheresis FP can be performed in a large blood bank setting without significant decreases in coagulation factor activities and thus without major impairment of the functional capacity of therapeutic plasma.

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Coagulation Factor Activity in Therapeutic Plasma Prepared from Whole Blood with Pathogen Inactivation (INTERCEPT™) Treatment.

Blood ◽

10.1182/blood.v108.11.4149.4149 ◽

2006 ◽

Vol 108 (11) ◽

pp. 4149-4149

Author(s):

Jean-Pierre Cazenave ◽

Hervé Isola ◽

Marie-Louise Wiesel ◽

Daniel Kientz ◽

Michel Laforêt ◽

...

Keyword(s):

Whole Blood ◽

Total Protein ◽

Frozen Storage ◽

Coagulation Factor ◽

Coagulation Factors ◽

Blood Collection ◽

Pathogen Inactivation ◽

Factor Activity ◽

Illumination Time ◽

Frozen Plasma

Abstract Background. A photochemical treatment (PCT) using amotosalen HCl (S-59) and UVA light was developed to inactivate pathogens and leukocytes in therapeutic plasma (INTERCEPT™, I-FFP) frozen within 8 hr of collection. Previous studies demonstrated a broad spectrum of pathogen inactivation (Transfusion2006;46:1168) and clinical efficacy of I-FFP for support of coagulopathies (Transfusion2005;45:1362; Blood2006; 107:3753), and plasma exchange of TTP (Transfusion 2006;46). Preparation of therapeutic plasma from whole blood would complement blood center logistics and reduce the cost of therapeutic frozen plasma provided sufficient coagulation factors were retained. Aims. We measured coagulation factors in plasma isolated from whole blood held overnight at controlled temperature (21 ± 3°C), processed with pathogen inactivation, and frozen within 18 hr of blood collection. Methods. Whole blood units, approximately 460 mL, anticoagulated with CPD (Baxter, La Chatre, France) were drawn from group A, O, B and AB donors. Units were processed after 16 hr storage, and plasma was isolated by centrifugation. Two to 3 plasma units of matched blood group were pooled (n = 30: A = 14, O = 14, B = 1, AB =1) to a final volume of 635 mL. Baseline samples for assay of coagulation factors were withdrawn. Each of 30 pools was mixed with 15 mL of 6 mM amotosalen (150 uM: final concentration) and illuminated with a 3 J/cm2 UVA treatment. Following illumination (~ 8 min) and passage through a flow compound adsorption device (~20 min) to reduce levels of residual S-59, treated plasma units (650 mL) were divided into 3 equal storage units of ≥ 200 mL. Before freezing, post-treatment samples for assay of coagulation factors were withdrawn for assay of coagulation factors. Treated plasma units were flash frozen at -80°C, and transferred to −30°C for 12-month storage. Treated units were withdrawn after 1 month to measure total protein, albumin, IgG, IgM, IgA, fibrinogen, factors II, V, VII, VIII, IX, X, XI, XII, VIII-vWF, Proteins C and S, AT III, plasminogen, alpha-2 antiplasmin, D-dimers, PT, and APTT. Results. Baseline coagulation factor levels (Mean ± SD) were in suitable therapeutic ranges. After PCT, all units had residual platelets < 1×109/L, WBC < 1×104/L, and RBC < 1 × 109/L. After PCT and frozen storage for 1 month, total protein (59 ± 2 g/L), albumin (38 ± 1 g/L), IgG (8.9 ± 1.1g/L), IgA (1.8 ± 0.4 g/L) and IgM (0.9 ± 0.3 g/L) were unchanged from baseline. Mean values for fibrinogen (g/L), coagulation factors (IU/dL), coagulation inhibitors (IU/dL), were variably reduced from baseline, but within ranges defined as suitable for therapeutic plasma (Table). There was no evidence of plasma activation. Conclusions. Plasma prepared from whole blood after storage on cooling plates before processing with the INTERCEPT system for pathogen inactivation retained coagulation factor activity levels after frozen storage (−30°C) in conformance with French national standards for therapeutic frozen plasma (FP). Approximately 36 units (200 mL) could be prepared per hr of illumination time with this system.

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Acquired Multiple Coagulation Factor Inhibitors Associated Bleeding Disorder

Blood ◽

10.1182/blood.v112.11.4511.4511 ◽

2008 ◽

Vol 112 (11) ◽

pp. 4511-4511

Author(s):

Qin-fen Chen ◽

Pei Li ◽

Yi Xie ◽

Bao-An Chen

Keyword(s):

Plasma Exchange ◽

Immunosuppressive Agents ◽

Clinical Manifestations ◽

Coagulation Factor ◽

Coagulation Factors ◽

Bleeding Disorder ◽

Thrombin Time ◽

Beneficial Effects ◽

First Case ◽

Frozen Plasma

Abstract Objective: To inquire into the clinical features of acquired multiple coagulation factors inhibitors associated bleeding disorder. Methods: A case of acquired multiple coagulation factors inhibitors in clinical manifestations, diagnosis, treatment and result was described and related literatures were reviewed. Results: A 74-year-old man developed sustained wound bleeding after implantation of heart pacemaker. Prothrombin time (PT), activated partial thromboplastin time (APTT) were prolonged significantly. But thrombin time (TT), fibrinogen (Fg), platelet count(PLT) and liver function were normal. 3P test was negative. Further tests revealed that the activities of factor 2, 5, 7,8,9,10,11,12 were all less than 10%, and the inhibitors of these factors could be detected, with the titers ranging from 8~64 Bu. So acquired multiple coagulation factor inhibitors was diagnosed. Transfusion with frozen plasma and cryoprecipitate was ineffective, whereas the combination therapy with glucocorticoid plus plasma exchange seemed to be successful. The patient was cured. Conclusion: Acquired multiple coagulation factors inhibitors is a rare bleeding disorder. In fact, this is the first case, as far as we are aware. It may develop serious bleeding. Immunosuppressive agents, such as corticosteroids, used for suppression of autoantibodies formation and plasma exchange, used for eradication of inhibitors may have beneficial effects.

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Fresh frozen plasma prepared with amotosalen HCl (S-59) photochemical pathogen inactivation: transfusion of patients with congenital coagulation factor deficiencies

Transfusion ◽

10.1111/j.1537-2995.2005.00216.x ◽

2005 ◽

Vol 45 (8) ◽

pp. 1362-1372 ◽

Cited By ~ 56

Author(s):

Pedro De Alarcon ◽

Richard Benjamin ◽

Marion Dugdale ◽

Craig Kessler ◽

Rinah Shopnick ◽

...

Keyword(s):

Coagulation Factor ◽

Fresh Frozen Plasma ◽

Pathogen Inactivation ◽

Fresh Frozen ◽

Frozen Plasma

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Thromboelastography - Viscoelastic Haemostatic Assay (VHA) Versus Routine Plasma Based Coagulation Parameters in Trauma Patients to Detect Coagulopathy within 24 Hrs After Injury

Blood ◽

10.1182/blood.v118.21.5248.5248 ◽

2011 ◽

Vol 118 (21) ◽

pp. 5248-5248

Author(s):

Bhaumik Arvindkumar Shah ◽

Arulselvi Subramanium ◽

Subhadra Sharma ◽

Deepak Agrawal ◽

Gaurav Chhabra ◽

...

Keyword(s):

Head Injury ◽

Prothrombin Time ◽

Whole Blood ◽

Partial Thromboplastin Time ◽

Activated Partial Thromboplastin Time ◽

Trauma Patients ◽

Thrombin Time ◽

Coagulation Parameters ◽

Conventional Methods ◽

D Dimer

Abstract Abstract 5248 In India trauma related deaths occur every 1.9 minutes. Mortality in severe traumatic injury (ISS>16) is six times higher in developing country like India. Coagulopathy is observed in almost 25– 30% of trauma patients which itself is an independent risk factor for haemorrhage. Coagulopathy detected early after injury is indicative of injury severity and itself is a prognostic factor for mortality. Aim To find out the usefulness of thromboelastography (TEG) in detecting coagulopathy in contrast to conventional methods of plasma based standard coagulation parameters (PT, aPTT, TT, fibrinogen, D-dimer) Objective To detect coagulopathy early by TEG in trauma patients within 24 hrs after injury which can be useful to guide haemostatic therapies to reduce mortality. Materials and methods Patients admitted to trauma casualty were studied within 24 hrs after injury. Native whole blood was withdrawn through venepuncture appropriately in syringe using 21G needle and TEG was performed within 2 mins. Blood was also collected in citrated tube to assess standard coagulation parameters (prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen, D-dimer) and also by means of thromboelastography. Results Patients (n=87,New ISS-24.78(mean)) admitted to J.P.N Apex trauma centre casualty from 1st April,2011 to 31st July,2011 were studied. The cases included in the study were isolated head injury (n=40, NISS-25.87(mean)), multiple trauma with head injury (n=13,NISS – 30.69 (mean)) and trauma other than head injury (n=34, NISS-21.24 (mean)).Thromboelastography was performed using whole blood (n=69) and citrated blood (n=18). Coagulation tests were performed on all 87 patients using both TEG and conventional coagulation parameters. Total 52 patients showed coagulopathy by TEG and only 14 patients showed coagulopathy by standard coagulation parameters (prothrombin time, activated partial thromboplastin time). Only in 10 cases coagulopathy was detected by both methods. 4 patients showed coagulopathy only by conventional methods while 42 patients showed coagulopathy by only Thromboelastography (TEG). To find out whether there is any stastistical significance in the observed apparently better result by TEG, McNemar Test was carried out and P value was <0.0001. Conclusion Thromboelastography could be a better technique as compared to conventional measurements of PT, aPTT, TT, Fibrinogen, D-dimer in early detection of coagulopathy in trauma patients. Disclosures: No relevant conflicts of interest to declare.

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Concentrated lyophilized plasma used for reconstitution of whole blood leads to higher coagulation factor activity but unchanged thrombin potential compared with fresh-frozen plasma

Transfusion ◽

10.1111/trf.14123 ◽

2017 ◽

Vol 57 (7) ◽

pp. 1763-1771 ◽

Cited By ~ 5

Author(s):

Giacomo E. Iapichino ◽

Martin Ponschab ◽

Janne Cadamuro ◽

Susanne Süssner ◽

Christian Gabriel ◽

...

Keyword(s):

Whole Blood ◽

Coagulation Factor ◽

Fresh Frozen Plasma ◽

Factor Activity ◽

Fresh Frozen ◽

Frozen Plasma

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Idarucizumab, a Specific Reversal Agent for Dabigatran: Immediate, Complete and Sustained Reversal of Dabigatran-Induced Anticoagulation in Japanese Healthy Male Volunteers

Blood ◽

10.1182/blood.v128.22.2627.2627 ◽

2016 ◽

Vol 128 (22) ◽

pp. 2627-2627 ◽

Cited By ~ 1

Author(s):

Joanne van Ryn ◽

Masahiro Yasaka ◽

Ippei Ikushima ◽

Akiko Harada ◽

Atsushi Taniguchi ◽

...

Keyword(s):

Plasma Concentrations ◽

Antibody Fragment ◽

Terminal Phase ◽

Thrombin Time ◽

Healthy Male ◽

Coagulation Parameters ◽

Reversal Agents ◽

Complete Reversal ◽

The Impact ◽

D Dimer

Abstract Background: Specific reversal agents for oral anticoagulants may be necessary to manage life-threatening bleeding or prior to emergency surgical procedures. While many reversal agents are in development, idarucizumab is approved and now available commercially in many countries. Idarucizumab is a humanized antibody fragment that specifically binds to dabigatran with high affinity and has shown immediate, complete and sustained reversal of dabigatran-induced anticoagulation in healthy male Caucasian volunteers. The present study investigated the safety, tolerability and pharmacokinetics of idarucizumab (part 1) and explored the effective dose of idarucizumab to reverse the dabigatran-induced anticoagulant effect (part 2) in healthy male Japanese volunteers. Methods: This was a two-part, phase I, randomized, placebo-controlled, double-blind, single-center, rising dose study. In part 1, subjects (n = 32) were randomized to receive either placebo (n = 2/dose group) or single intravenous doses of idarucizumab, 1, 2, or 4 g as a 5-minute infusion or 8 g as a 1-hour infusion (n = 6/group). In part 2, subjects (n = 48) were treated orally for 3 days with dabigatran etexilate (DE, 220 mg bid). On day 4, subjects received a final DE dose, followed a 3-day wash out period. Subjects were again treated orally for 3 days with DE, 220 mg bid. On Day 11, subjects received a final DE dose followed 2 hours later by placebo (n = 3/group) or idarucizumab (1, 2, 4, or 5 g [2.5 g followed by 2.5 g given 15 minutes apart]) as a 5-minute intravenous infusion, n = 9/group). The number of subjects with adverse events (AEs), emergence of anti-idarucizumab antibodies (ADAs), pharmacokinetics and the impact of idarucizumab on coagulation parameters were assessed (diluted thrombin time, ecarin clotting time, activated partial thromboplastin time, and thrombin time). In addition, potential procoagulant effects were monitored as D-dimer and prothrombin fragment F1.2. Results: Idarucizumab attained a maximum concentration in plasma around the end of each infusion followed by a biphasic decline in plasma concentrations with a rapid initial phase and a longer terminal phase.. Dabigatran treatment prolonged the clotting times of all coagulation parameters. Idarucizumab infusion resulted in immediate and complete reversal of dabigatran-induced anticoagulation, reducing coagulation parameters below the upper limit of normal. The duration was dose-dependent; at 4 and 5 g of idarucizumab, complete reversal was sustained up to 72 hours, at lower doses ≤ 2 g a partial return of the anticoagulation activity of dabigatran was observed 1-2 hours after idarucizumab administration. Concentration of unbound dabigatran decreased to below the limit of quantification immediately after administration of a single dose of idarucizumab. Idarucizumab was safe and well tolerated, and no AEs were reported. There was no elevation of either D-dimer or F1.2 levels post idarucizumab as compared to levels prior to infusion in any of the dose groups. Treatment-emergent ADAs occurred in 6 of 60 patients receiving idarucizumab. Conclusion: Idarucizumab infusion achieved immediate, complete and sustained reversal of dabigatran-associated anticoagulation in healthy male Japanese volunteers. Idarucizumab was safe and well tolerated with no procoagulant effects. Disclosures van Ryn: Boehringer Ingelheim: Employment. Yasaka:Sanofi: Research Funding; Nippon Boehringer Ingelheim: Other: received lecture fees (over 1 million Yen); Bristol-Myers Squibb: Other: received lecture fees (over 1 million Yen); Bayer Yakuhin: Other: received lecture fees (over 1 million Yen); Daiichi-Sankyo: Other: received lecture fees (over 1 million Yen). Harada:Boehringer Ingelheim: Employment. Taniguchi:Boehringer Ingelheim: Employment. Imazu:Boehringer Ingelheim: Employment. Norris:Boehringer Ingelheim: Employment. Gansser:Boehringer Ingelheim: Employment. Stangier:Boehringer Ingelheim: Employment.

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Blood transfusion in horses

Veterinarski glasnik ◽

10.2298/vetgl1002137t ◽

2010 ◽

Vol 64 (1-2) ◽

pp. 137-142

Author(s):

Dragisa Trailovic ◽

Sasa Laus ◽

Stefan Djokovic

Keyword(s):

Blood Transfusion ◽

Blood Loss ◽

Blood Coagulation ◽

Fluid Therapy ◽

Whole Blood ◽

Coagulation Factor ◽

Blood Groups ◽

Blood Bank ◽

Fresh Blood ◽

Efficient Manner

Fluid therapy includes blood transfusion which presents the most efficient manner of treating hypovolaemia caused by blood loss, even though whole blood can be used as a therapeutic means in other cases as well - in deficits of the blood coagulation factor, exhaustion of the antiprotease system, hypoproteinaemia, primarily hypoalbuminaemia, and others. The application of fresh blood has an advantage over preserved blood, which does not lessen the importance of setting up a blood bank, in particular in cases when the blood groups of the donors are precisely determined. .

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Coagulation profile of human COVID-19 convalescent plasma

Scientific Reports ◽

10.1038/s41598-021-04670-1 ◽

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.

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EspP, An Extracellular Serine Protease From Enterohemorrhagic E. Coli, Induces Coagulopathy In Human Whole Blood and Plasma

Blood ◽

10.1182/blood.v116.21.4416.4416 ◽

2010 ◽

Vol 116 (21) ◽

pp. 4416-4416

Author(s):

Kevin H.M. Kuo ◽

Shekeb Khan ◽

Elena Brnjac ◽

Emil F. Pai ◽

Alden E. Chesney

Keyword(s):

Serine Protease ◽

Whole Blood ◽

Ex Vivo ◽

Coagulation Factor ◽

Time Dependent ◽

Coagulation Cascade ◽

Factor V ◽

Dependent Manner ◽

E Coli ◽

Negative Controls

Abstract Abstract 4416 EspP (E. coli secreted serine protease, large plasmid encoded) is an extracellular serine protease produced by enterohemorrhagic E. coli (EHEC) O157:H7. Brunder et al. (Mol Microbiol 1997, 24:767–78) have shown that EspP cleaves, amongst other proteins, human coagulation factor V, and the authors hypothesized that it may contribute to the mucosal hemorrhage in patients with EHEC infection. We have since shown that EspP also cleaves factor VIII. Since the mechanism by which EHEC induces diarrhea-associated Hemolytic Uremic Syndrome (D+HUS) has not been fully elucidated, and EspP has been cited as a putative virulence factor in D+HUS, we investigated the role of EspP in primary and secondary hemostasis in the pathogenesis of D+HUS. Wild type EspP (EspPwt) and EspPS263A, where the serine at the active site was mutated to an alanine thereby abolishing its proteolytic activity, were expressed in the non-pathogenic E. coli host BL21(DE3) and purified by hydrophobic interaction and size-exclusion chromatography. EspPwt at 1.0 mg/mL was incubated for 0.5, 2.0 and 4.0 hours ex vivo with citrated plasma from 6 healthy adults. EspPS263A, bovine serum albumin (BSA) and phosphate buffer saline-glycerol (PBS-G) served as negative controls. PT, aPTT and TT were found to be significantly prolonged and activity of factors V, VII, VIII and XII were reduced in a time- and concentration-dependent manner (Figures 1 and Figure 2). When citrated plasma was incubated with 1 mg/mL EspPwt at 37°C for 4 hours, PT was prolonged by 23.2 +/− 3.8 s, aPTT by 41.6 +/− 8.3 s and TT by 6.1 +/− 0.6 s, relative to the negative controls. Factor V activity decreased by 0.82 +/− 0.14 U/mL, factor VII by 0.72 +/− 0.28 U/mL, factor VIII by 0.69 +/− 0.31 U/mL and factor XII by 0.36 +/− 0.09 U/mL, relative to the negative controls. Prothrombin activity was significantly reduced (0.16 +/− 0.08 U/mL) compared to all negative controls but remained above 0.75 U/mL. Factors IX, × and XI activity, and fibrinogen concentration were not significantly different from the controls. To determine whether any cellular components in whole blood contribute to EspP's effect on the coagulation cascade, the experiment was repeated using citrated whole blood in place of plasma during the incubation phase. Plasma was then recovered and analyzed. Similar results were observed. The results suggest that EspP has proteolytic activity against specific coagulation factors at least in an ex vivo setting. In patients with EHEC infection, EspP may contribute to the hemorrhagic diarrhea by impairing the coagulation cascade. Further studies are needed to determine whether EspP is able to induce coagulopathy in vivo and if so, whether induction of such a coagulopathic state may favour the entry of Shiga toxin into systemic circulation in patients with D+HUS. Figure 1 EspP prolongs PT, aPTT and TT in a time-dependent manner. Figure 1. EspP prolongs PT, aPTT and TT in a time-dependent manner. Figure 2 EspP reduces coagulation factor activity in a time-dependent manner. Figure 2. EspP reduces coagulation factor activity in a time-dependent manner. Disclosures: No relevant conflicts of interest to declare.

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Pathogen inactivation in fresh frozen plasma using riboflavin and ultraviolet light: Effects on plasma proteins and coagulation factor VIII

Vojnosanitetski pregled ◽

10.2298/vsp1101051s ◽

2011 ◽

Vol 68 (1) ◽

pp. 51-56 ◽

Cited By ~ 1

Author(s):

Zoran Stanojkovic ◽

Ana Antic

Keyword(s):

Uv Light ◽

Coagulation Factor ◽

Fresh Frozen Plasma ◽

Albumin Concentration ◽

Pathogen Inactivation ◽

Significant Difference ◽

Fresh Frozen ◽

Control Plasma ◽

Frozen Plasma ◽

Uv Rays

Background/Aim. Riboflavin (vitamin B2) activated by ultraviolet (UV) light, produces active oxygen which damages cell membrane and prevents replication of the carrier of diseases (viruses, bacteria, protozoa) in all blood products. The aim of this study was to establish the influence of the process of photo inactivation in pathogens using riboflavin and UV rays on the concentration of coagulation factor VIII:C (FVIII:C) and proteins in plasma that were treated before freezing. Methods. The examination included 20 units of plasma, separated from whole blood donated by voluntary blood donors around 6 hours from the moment of collection. The units were pooled and separated in to two groups: one consisted of 10 control units and the other of 10 experimental units. Experimental units of the plasma were treated by riboflavin (35 mL) and UV rays (6.24 J/mL, 265-370 nm) on Mirasol aparature (Caridian BCT Biotechnologies, USA) in approximate duration of 6 minutes. Furthermore, 35 mL of saline solution was added to the control plasma. One sample for examining was taken from the control plasma (KG) and two residual were taken from experimental plasma after the addition of riboflavin either before (EG1) or post illumination (EG2). Results. Comparing the mean values of FVIII:C (%) we noticed statistically significantly higher level in the EG1 group than in the EG2 group (65.00 ? 4.52 vs 63.20 ? 4.73; t = 4.323, p = 0.002), while between the KG and experimental groups (EG1 and EG2) there was no statistically significant difference in the concentration of FVIII:C. There was a statistically significant decrease of albumin concentration (g/L) in the EG2 group comparing to the KG (33.35 ? 0.94 vs 31.94 ? 0.84; t = 3.534, p = 0.002), but there was no mentioned difference in albumin concentration between the KG and the EG1, so as between the EG1 and the EG2. Conclusion. Plasma inactivated by riboflavin and UV rays (Mirasol PRT sistem, Caridian BCT, USA) keeps all the characteristics of conventional plasma, so it could be used for the treatment of pathological conditions that demand transfusion of fresh frozen plasma, or in patients with thrombotic thrombocytopenic purpure when we use therapeutic exchange of plasma.

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