Stability of coagulation factors in feline fresh frozen plasma intended for transfusion after 1 year of storage

Abstract

Objectives The most common use of plasma transfusion is for haemostatic purposes, but coagulation factor activities in stored feline plasma are unknown. The concentration and stability of coagulation factors I (fibrinogen), II, V, VII, VIII, IX, X, XI and XII in feline fresh frozen plasma (fFFP) stored for 1 year were studied. Methods Fifty-five units of fFFP were produced from 55 fresh whole-blood donations obtained from indoor healthy blood donor cats. Twenty-one units were stored for <2 weeks (T0) and 34 were stored for 1 year (T1). After the completion of storage, specific coagulation factor activities for factors II, V, VII, VIII, IX, X, XI and XII were tested using modified one-stage activated partial thromboplastin or prothrombin time assays. Fibrinogen was determined using the Clauss method. Results Significantly decreased activities were observed for factors II (T0: 101.94% ± 19.06%; T1: 73.23% ± 39.06% [ P = 0.001]), VII (T0: 102.78% ± 24.69%; T1: 60.08% ± 38.17% [ P <0.001]), VIII (T0: 77.52% ± 30.39%; T1: 50.32% ± 23.8% [ P = 0.001]), XI (T0: 88.76% ± 22.73%; T1: 66.28% ± 22.2% [ P = 0.001]) and XII (T0: 89.50% ± 21.85%; T1: 55.46% ± 23.18% [ P <0.001]) when comparing units at time 0 and after 1 year of storage. No significant difference was observed for factors IX (T0: 84.86% ± 29.35%; T1: 71.37% ± 22.23% [ P = 0.064]) and X (T0: 96.24% ± 25.1%; T1: 83.91% ± 49.54% [ P = 0.236]). Unexpectedly, a significant increase was observed for factor V (T0: 71.94% ± 24.14%; T1: 97.89% ± 62.33%; P = 0.046). Fibrinogen was 2.76 ± 1.09 g/l at T1. Factors VIII, XII and VII had the lowest mean activities after 1 year. Conclusions and relevance Although a decrease in most coagulation factors activities was noted with storage, 1-year-old fFFP was haemostatically active in vitro. The most suitable factors for quality control assessment of fFFP are factors VII and VIII. Approximately 13–20 ml/kg of fFFP is required to administer a minimum of 10 IU/kg coagulation factor activity.

Using plasma products in small animal practice

“…Fresh plasma (or fresh frozen plasma [FFP]) contains both labile and stable clotting factors, as well as other proteins important for haemostasis, such as fibrinogen (factor 1) and the glycoprotein known as von Willebrand factor (vWf). The activity of the labile clotting factors (factor 5 and 8), fibrinogen and vWf generally decreases more rapidly than the stable, or non‐labile, clotting factors, resulting in varying factor quantities based on length of plasma product storage (Silverstein and Hart 2019, Blasi‐Brugué and others 2022).…”