Does Long-term Storage Alter the Haemostatic Potential and Balance of Transfusion Plasma After Thawing?

Recently, storage of thawed plasma for up to 7 days was discussed as a potential solution to eliminate time loss for thawing in the supply of fresh-frozen plasma (FFP) in bleeding emergencies. The objective of our study was to assess the quality and haemostatic potency of thawed FFP units during long-term storage at either +4°C or room temperature. A substantial reduction of activities of several coagulation factors and inhibitors, especially of FV, FVIII and protein S, occurred during storage at both temperatures. Activation markers of coagulation and fibrinolysis, such as FVIIa, TAT, F1+2 or D-dimer, increased to different extents. Furthermore, thrombin generation potential substantially decreased, accompanied with a prolongation of the lag times. Single FFP units became extremely turbid during long-term storage of thawed plasma and shifted to acidic pH levels. Based on these data, thawed plasma should be administered in compliance with current transfusion guidelines.