Liquid Plasma vs Thawed Plasma: Tracking Coagulation Factor Activity Changes During Storage

Background and ObjectivesLiquid plasma (LQP) stands out as an alternative to thawed plasma (TP) for emergent transfusions due to longer shelf life. We aim to measure fibrinogen, Protein C, Protein S, FV, FVII, and FVIII activity in LQP, quantify how these factors levels change during storage, and characterize how they compare in LQP to TP. Materials and MethodsCoagulation factor activities were measured on Days 15, 26, and 27 for LQP (n=26) and Day 5 for TP (n=31). Bayesian statistics was used to compare coagulation factor activity and quantify changes in activity during storage. ResultsFibrinogen and Protein C activity in Day 26 LQP (LQP26) was comparable to Day 5 TP (TP5) with posterior mean activity of 257 mg/dL vs 246 mg/dL and 100.4% vs 108.7%, respectively. FV, FVII, and FVIII had lower activity in LQP26 vs TP5 with posterior mean activities of 42.6% vs 72.0%, 55.0% vs 59.7%, and 48.8% vs 59.2%, respectively. Protein S in LQP26 was low with posterior mean activity of 28.0%, which was less than half that of TP5 at 66.4%. From Day 15 to Day 26, FVII in LQP decreased at a rate of -3.49% per day whereas fibrinogen, Protein C, Protein S, FV, and FVIII activity in LQP remained relatively stable. ConclusionCompared to TP5, LQP26 has comparable activities of fibrinogen, Protein C, FVII, lower activities of FV and Protein S, and slightly lower activity of Factor VIII. LQP is a viable alternative for use in emergency transfusions and massive transfusion protocols. Highlights- Liquid plasma has comparable activities to thawed plasma for fibrinogen, Protein C, and Factor VII, which is advantageous for emergency use due to its extended shelf life. - Liquid plasma has adequate fibrinogen and Protein C levels on the last day of expiration. - Liquid plasma has [~]50% FV, FVII and FVIII activity levels on the last day of expiration, making it a sufficient replacement option to TP for active bleeding.