TY - JOUR
T1 - Hemostatic properties of cold-stored whole blood leukoreduced using a platelet-sparing versus a non–platelet-sparing filter
AU - Haddaway, Kathy
AU - Bloch, Evan M.
AU - Tobian, Aaron A.R.
AU - Frank, Steven M.
AU - Sikorski, Robert
AU - Cho, Brian C.
AU - Zheng, Gang
AU - Jani, Jayesh
AU - Lokhandwala, Parvez M.
AU - Lawrence, Courtney E.
AU - Blagg, Lorraine
AU - Ness, Paul M.
AU - Kickler, Thomas S.
AU - Gehrie, Eric A.
PY - 2019/5
Y1 - 2019/5
N2 - BACKGROUND: Whole blood (WB) is an appealing alternative to component-based transfusion in patients with significant bleeding. Historically, WB was transfused less than 48 hours after collection and was not leukoreduced (LR). However, LR components are now standard in many hospitals and LR WB is desirable. We investigated the effect of the type of LR filter used, as well as storage duration, on coagulation laboratory testing of WB. STUDY DESIGN AND METHODS: Ten units of LR WB—5 units manufactured with a Food and Drug Administration (FDA)-approved platelet (PLT)-sparing filter (WB-PS) and 5 units manufactured with an FDA-approved non–PLT-sparing filter (WB-NPS)—underwent complete blood count, PLT function analyzer (PFA [PFA-100]), thromboelastography (TEG), prothrombin time (PT), partial thromboplastin time (PTT), Factor (F)V activity, chromogenic FVIII, thrombin generation, and microparticle quantification on Storage Days 3, 5, 7, 10, and 14. RESULTS: WB-PS contains more PLTs than WB-NPS (mean, 71 × 10 9 /L vs. 1 × 10 9 /L, p < 0.001). WB-PS yielded essentially normal TEG tracings, while TEG tracings of WB-NPS were grossly abnormal (mean reaction time, 7.0 min for WB-PS vs. 9.7 min for WB-NPS, p < 0.001; mean alpha-angle 54.9° vs. 38.1°, p < 0.001; mean maximum amplitude, 54.9 mm vs. 13.9 mm, p < 0.001). PFA-100 closure was more common among units of WB-PS compared to units of WB-NPS (72% vs. 4%, p < 0.001). PT, PTT, and factor activities were not dramatically affected by the LR filter. CONCLUSION: The choice LR filter has a major impact on the hemostatic properties of WB. Although storage of WB is associated with a rapid decline in PLT count, hemostasis as assessed by TEG and PFA-100 is not diminished over a 2-week storage period.
AB - BACKGROUND: Whole blood (WB) is an appealing alternative to component-based transfusion in patients with significant bleeding. Historically, WB was transfused less than 48 hours after collection and was not leukoreduced (LR). However, LR components are now standard in many hospitals and LR WB is desirable. We investigated the effect of the type of LR filter used, as well as storage duration, on coagulation laboratory testing of WB. STUDY DESIGN AND METHODS: Ten units of LR WB—5 units manufactured with a Food and Drug Administration (FDA)-approved platelet (PLT)-sparing filter (WB-PS) and 5 units manufactured with an FDA-approved non–PLT-sparing filter (WB-NPS)—underwent complete blood count, PLT function analyzer (PFA [PFA-100]), thromboelastography (TEG), prothrombin time (PT), partial thromboplastin time (PTT), Factor (F)V activity, chromogenic FVIII, thrombin generation, and microparticle quantification on Storage Days 3, 5, 7, 10, and 14. RESULTS: WB-PS contains more PLTs than WB-NPS (mean, 71 × 10 9 /L vs. 1 × 10 9 /L, p < 0.001). WB-PS yielded essentially normal TEG tracings, while TEG tracings of WB-NPS were grossly abnormal (mean reaction time, 7.0 min for WB-PS vs. 9.7 min for WB-NPS, p < 0.001; mean alpha-angle 54.9° vs. 38.1°, p < 0.001; mean maximum amplitude, 54.9 mm vs. 13.9 mm, p < 0.001). PFA-100 closure was more common among units of WB-PS compared to units of WB-NPS (72% vs. 4%, p < 0.001). PT, PTT, and factor activities were not dramatically affected by the LR filter. CONCLUSION: The choice LR filter has a major impact on the hemostatic properties of WB. Although storage of WB is associated with a rapid decline in PLT count, hemostasis as assessed by TEG and PFA-100 is not diminished over a 2-week storage period.
UR - http://www.scopus.com/inward/record.url?scp=85061454194&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85061454194&partnerID=8YFLogxK
U2 - 10.1111/trf.15159
DO - 10.1111/trf.15159
M3 - Article
C2 - 30741432
AN - SCOPUS:85061454194
SN - 0041-1132
VL - 59
SP - 1809
EP - 1817
JO - Transfusion
JF - Transfusion
IS - 5
ER -