Background: Reduced levels of protein S (PS) and α₂-antiplasmin α₂-AP) in solvent/detergent virus-inactivated plasma (S/D-VIP) might induce an imbalance of plasma coagulation factors and inhibitors in patients transfused. We investigated 40 patients (23 fresh frozen plasma (FFP), 17 S/D-VIP, random distribution by a list calculated by statisticians) who suffered from dilution coagulopathy, liver disease, disseminated intravascular coagulation (DIC), polytrauma or were connected to extracorporeal circulation. Study Design and Methods: The following markers of activated coagulation (MAC) were measured: Prothrombin fragment F1+2 (F1+2), fibrin monomers (FM), D-dimers (DD), thrombin-antithrombin (TAT) and plasmin-antiplasmin (PAP) complexes as well as fibrinogen degradation products (FgDP), and additionally antithrombin III (antithrombin), protein C (PC), PS and α₂-AP. Blood was taken only just before and 1 h after the first plasma replacement (2 units). No additional blood products were transfused before the second blood withdrawal. Pre- and posttransfusion (pre/post) values of all parameters measured were compared within the same group and between both groups. Statistical evaluation of the data was done by Wilcoxon’s paired test for data in the same plasma group and by the test of Mann and Whitney for data comparison between both plasma groups. Results: Average pretransfusion values of all inhibitors for both plasma groups were in the same range and increased after transfusion, except for PS in both groups. Whereas the pre/post values did not differ significantly in the FFP group, antithrombin (p = 0.02), PC (p = 0.0005), and α₂-AP (p = 0.02) showed a significantly higher increase in the S/D-VIP group. Considering the pre/post differences between both plasma groups, there were no significant differences. The same was true for MAC measured pre- and posttransfusion. Conclusion: Data showed no significant difference between both plasma groups, indicating that S/D-VIP plasma behaves as FFP under the study conditions employed.

Background: Microwaves basically are a quick alternative to water bath and water bag system (WB) for thawing of fresh frozen plasma (FFP) for transfusion. Already in the 1980s we developed, together with a manufacturer (Infusotherm, Zeipel, Göttingen, Germany), a microwave oven (MWO) which allowed thawing of FFP much faster and more gentle than with WB. With the addition of e.g. methylene blue or solvents and detergents to plasma for virus inactivation, the question arises if microwaves might have a negative impact on virus-inactivated plasma (VIP) by enhancing activation processes or impairment of proteins which have been initiated by the inactivation procedure, resulting in reduced hemostatic activity. Material and Methods: 30 solvent/detergent-inactivated plasma (SDP), 25 methylene blue-inactivated plasma (MBP), and 30 conventionally produced FFP units were investigated immediately and 2 h after thawing by MWO and a modified WB system for the following coagulation parameters: All plasma clotting factors and the corresponding complex coagulation tests, prothrombin fragment F1+2, d-dimers, thrombin-antithrombin, plasmin-antiplasmin, fibrinogen degradation products, reptilase and thrombin time, antithrombin, protein C, protein S, α2-antiplasmin, von Willebrand factor antigen, Ristocetin cofactor, and von Willebrand factor multimers. The effect on primary hemostasis was investigated by means of in vitro bleeding test (IVBT; Thrombostat 4000, VDG, Seeon, Germany) by addition of plasma to fresh blood of healthy donors. Results: Reaching comparable end temperature (MWO: SDP 31.4 °C, MBP 31.6 °C, FFP 31.7 °C; WB: SDP 32.2 °C, MBP 31.8 °C, FFP 31.5 °C), thawing with MWO (SDP 16.3 min, MBP 19.7 min, FFP 19.5 min) was considerably shorter than with WB (SDP 31.2 min, MBP 31.8 min, FFP 32 min). Under these conditions no significant differences of the hemostatic parameters which could be attributed to the thawing method were found. Only the known differences between the different plasma types which are due to production and inactivation process have been proven. Conclusion: The used MWO is suitable for thawing of FFP as well as VIP. In regard to the significant shorter thawing time, it has clear advantages, particularly in massive transfusion.