Effect of solvent/detergent-treated pooled plasma on fibrinolysis in reconstituted whole blood.
Transfusion
; 57(10): 2381-2389, 2017 10.
Article
em En
| MEDLINE
| ID: mdl-28727139
ABSTRACT
BACKGROUND:
Hyperfibrinolysis has been observed in patients heavily transfused with solvent/detergent-treated pooled plasma (S/D plasma). We compared coagulation and fibrinolytic variables in blood containing S/D plasma with blood containing fresh-frozen plasma (FFP), with and without α2-antiplasmin or tranexamic acid (TXA) supplementation. STUDY DESIGN ANDMETHODS:
Whole blood samples were reconstituted from red blood cells, platelet (PLT) concentrates, and varying mixtures of FFP and S/D plasma. Hematocrit and PLT count of reconstituted whole blood samples were varied. For a subset of runs, α2-antiplasmin or TXA was added to S/D plasma whole blood samples. Thromboelastography (TEG) analysis was performed to assess 50% clot lysis time (CLT50% ), maximum amplitude (MA), and initial clotting time (R-time).RESULTS:
The change in CLT50% of whole blood as the plasma compartment transitions from FFP to S/D plasma was -52% (95% confidence interval [CI], -60% to -45%; p < 0.001). PLT count strengthened the effect, leading to an additional change in CLT50% of -8% (95% CI, -14% to -2%; p = 0.012) as PLT count increased from 10 × 109 to 150 × 109 /L. MA and R-time were not associated with fraction of S/D plasma in whole blood. α2-Antiplasmin and TXA restored clot lysis time in S/D plasma whole blood.CONCLUSION:
Whole blood with S/D plasma has shorter clot lysis times in vitro compared to whole blood with FFP. α2-Antiplasmin and TXA restore clot lysis time of S/D plasma whole blood to that of FFP whole blood. Clinicians should be aware of the decreased clot lysis time associated with S/D plasma transfusion.
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Base de dados:
MEDLINE
Assunto principal:
Plasma
/
Solventes
/
Coagulação Sanguínea
/
Detergentes
/
Fibrinólise
Limite:
Humans
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article