Several studies have demonstrated that the activity of most clotting factors are well maintained in FP24 5 and some transfusion services use FFP and FP24 interchangeably for the first 24 hours after thawing 3. Holding blood overnight could contribute to a reduction in the risk of TRALI by increasing the number of “male-only” donations available for FFP production 5, 6. UK haemovigilance data showed that HLA antibody-positive female donors are the principal cause of TRALI associated with FFP. The prevalence of anti-HLA antibodies is highest in donors who have previously been pregnant.
Typically the reactions causing these injury are mediated by donor anti-HLA or neutrophil-specific antibodies, which bind to recipient neutrophils leading to non-cardiogenic pulmonary oedema, hypoxia, and sometimes death 4. Plasma from whole blood stored overnight at 4 ☌ can be made into plasma frozen within 24 hours after phlebotomy (FP24) but because of the 20 to 30% loss of factor VIII (FVIII) activity, this plasma does not consistently meet European or United Kingdom (UK) guidelines for transfusable plasma 2.Ī growing concern regarding plasma transfusion is the risk of transfusion-related acute lung injury (TRALI) 3.
There is increasing interest in producing components from blood that has been stored for 24 hours.
Production of frozen plasma after overnight storage of whole blood greatly increases operational flexibility, which can indirectly enhance component safety. Transfusion of fresh-frozen plasma (FFP) is indicated to replace deficiencies of multiple coagulation factors and control proteins in massive blood loss, liver disease, and disseminated intravascular coagulation 1.
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