Seven Day Storage At 4

1
Seven Day Storage At 4C Of Previously -80C
Frozen AB Plasma

• Sm. Remco Strelitski, BSc
• Chief Lab technician, Military Blood Bank,
  Netherlands.

NATO 2009
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TRANSFUSION AND TRAUMACoagulopathy and massive
transfusion
Borgman MA, et. al, J Trauma, Oct, 2007.
Ratio 11 RBCPlasma improves survival
rates Early transfusion of plasma is recommended
NATO 2009
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NLD MILITARY BLOOD BANKProduction of -80C
frozen plasma
Leukodepleted, apheresis unit of FFP (- 30C) is
thawed, repacked and frozen to - 80C at the MBB
AB FFP - 30C ( 0.7 years)
- 80C ( 7 years)
Thaw Freeze
AB DFP
In theater, the unit is thawed and warmed to
30º C
30 min
AB Plasma
30C
AB DFP
Thaw
3
4
NLD MILITARY BLOOD BANKProducts preparation time
and availability
AIM OF STUDY Improved availability of
plasma Storage time of thawed AB -80C Plasma at
4C?
NATO 2009
5
Pilot storage of units at 4C for 6 weeks
Storage of samples in vials at -80C
FV
FVII
FVIII
APTT
PT
Fib
Data of frozen samples were different from fresh
samples Project continued with fresh samples
NATO 2009
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RESULTSAPTT and Factor VIII
NATO 2009
7
RESULTSINR (PT), Factor V and Factor VII
NATO 2009
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RESULTS
Average product volume 3107 mL Average
fibrinogen content 0,95 gram/unit at day 7
NATO 2009
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Clinical relevance of guidelines 70 vs 50?
Coagulation time (sec)
FVIII
FV
FVII
Activity ()
NATO 2009
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Conclusions
3/29/2012

• At 7 days FVIII and FV activity are well above
  50
• Fibrinogen activity is reduced on day 14 at 4C
• -80C AB Plasma can be stored for 7 days at 4C
  without clinically significant loss of its
  clotting capacity
• Since April 2009, 137 stored units have been
  transfused without any untoward effects reported
• In addition, mutual support between MTF in
  Afghanistan became easier by using 4C cold chain.

NATO 2009
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11
Future application 4C plasmaProduction of
thawed -80C frozen platelets?
- 80C (2 years)
Platelets
30C
5 min
Platelets
DMSO (5 w/v)
DMSO (5, 14 ml)

30C
30 min
AB DFP - 80C
AB Plasma
Platelets
AB Plasma
DMSO ( 0.2)
Leukodepleted unit of (apheresis) platelets is
frozen and concentrated in 5 DMSO plasma. In
theater, after 5 min of thawing, the PLTs are
reconstituted in thawed -80C plasma
11
12
Future application 4C plasmaProduction of
thawed -80C frozen platelets?
AIM OF STUDY Improved availability of
plasma Storage time of thawed AB -80C Plasma at
4C?
NATO 2009