TY - JOUR
T1 - Hemostatic In Vitro Properties of Novel Plasma Supernatants Produced from Late-storage Low-titer Type O Whole Blood
AU - Mihalko, Emily P.
AU - Srinivasan, Amudan J.
AU - Rahn, Katelin C.
AU - Seheult, Jansen N.
AU - Spinella, Philip C.
AU - Cap, Andrew P.
AU - Triulzi, Darrell J.
AU - Yazer, Mark H.
AU - Neal, Matthew D.
AU - Shea, Susan M.
N1 - Funding Information:
The University of Pittsburgh holds a Physician-Scientist Institutional Award from the Burroughs Wellcome Fund (Research Triangle Park, North Carolina; Dr. Srinivasan). Research reported in this publication was supported by the National Institute of General Medical Sciences of the National Institutes of Health (Bethesda, Maryland) under award No. T32GM008516. This work was supported in part by the National Institute of General Medical Sciences (R35GM119526-05 to Dr. Neal), and Dr. Shea is supported by the National Heart, Lung, and Blood Institute (K25HL161401-01).
Funding Information:
The University of Pittsburgh holds a Physician-Scientist Institutional Award from the Burroughs Wellcome Fund (Research Triangle Park, North Carolina; Dr. Srinivasan). Research reported in this publication was supported by the National Institute of General Medical Sciences of the National Institutes of Health (Bethesda, Maryland) under award No. T32GM008516. This work was supported in part by the National Institute of General Medical Sciences (R35GM119526-05 to Dr. Neal), and Dr. Shea is supported by the National Heart, Lung, and Blood Institute (K25HL161401-01).
Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.
PY - 2023/7/1
Y1 - 2023/7/1
N2 - Background: The use of low-titer group O whole blood is increasing. To reduce wastage, unused units can be converted to packed red blood cells. Supernatant is currently discarded post-conversion; however, it could be a valuable transfusable product. The aim of this study was to evaluate supernatant prepared from late-storage low-titer group O whole blood being converted to red blood cells, hypothesizing it will have higher hemostatic activity compared to fresh never-frozen liquid plasma. Methods: Low-titer group O whole blood supernatant (n = 12) prepared on storage day 15 was tested on days 15, 21, and 26 and liquid plasma (n = 12) on 3, 15, 21, and 26. Same-day assays included cell counts, rotational thromboelastometry, and thrombin generation. Centrifuged plasma from units was banked for microparticle characterization, conventional coagulation, clot structure, hemoglobin, and additional thrombin generation assays. Results: Low-titer group O whole blood supernatant contained more residual platelets and microparticles compared to liquid plasma. At day 15, low-titer group O whole blood supernatant elicited a faster intrinsic clotting time compared to liquid plasma (257 ± 41 vs. 299 ± 36 s, P = 0.044), and increased clot firmness (49 ± 9 vs. 28 ± 5 mm, P < 0.0001). Low-titer group O whole blood supernatant showed more significant thrombin generation compared to liquid plasma (day 15 endogenous thrombin potential 1,071 ± 315 vs. 285 ± 221 nM·min, P < 0.0001). Flow cytometry demonstrated low-titer group O whole blood supernatant contained significantly more phosphatidylserine and CD41+microparticles. However, thrombin generation in isolated plasma suggested residual platelets in low-titer group O whole blood supernatant were a greater contributor than microparticles. Additionally, low-titer group O whole blood supernatant and liquid plasma showed no difference in clot structure, despite higher CD61+microparticle presence. Conclusions: Plasma supernatant produced from late-storage low-titer group O whole blood shows comparable, if not enhanced, in vitro hemostatic efficacy to liquid plasma.
AB - Background: The use of low-titer group O whole blood is increasing. To reduce wastage, unused units can be converted to packed red blood cells. Supernatant is currently discarded post-conversion; however, it could be a valuable transfusable product. The aim of this study was to evaluate supernatant prepared from late-storage low-titer group O whole blood being converted to red blood cells, hypothesizing it will have higher hemostatic activity compared to fresh never-frozen liquid plasma. Methods: Low-titer group O whole blood supernatant (n = 12) prepared on storage day 15 was tested on days 15, 21, and 26 and liquid plasma (n = 12) on 3, 15, 21, and 26. Same-day assays included cell counts, rotational thromboelastometry, and thrombin generation. Centrifuged plasma from units was banked for microparticle characterization, conventional coagulation, clot structure, hemoglobin, and additional thrombin generation assays. Results: Low-titer group O whole blood supernatant contained more residual platelets and microparticles compared to liquid plasma. At day 15, low-titer group O whole blood supernatant elicited a faster intrinsic clotting time compared to liquid plasma (257 ± 41 vs. 299 ± 36 s, P = 0.044), and increased clot firmness (49 ± 9 vs. 28 ± 5 mm, P < 0.0001). Low-titer group O whole blood supernatant showed more significant thrombin generation compared to liquid plasma (day 15 endogenous thrombin potential 1,071 ± 315 vs. 285 ± 221 nM·min, P < 0.0001). Flow cytometry demonstrated low-titer group O whole blood supernatant contained significantly more phosphatidylserine and CD41+microparticles. However, thrombin generation in isolated plasma suggested residual platelets in low-titer group O whole blood supernatant were a greater contributor than microparticles. Additionally, low-titer group O whole blood supernatant and liquid plasma showed no difference in clot structure, despite higher CD61+microparticle presence. Conclusions: Plasma supernatant produced from late-storage low-titer group O whole blood shows comparable, if not enhanced, in vitro hemostatic efficacy to liquid plasma.
UR - http://www.scopus.com/inward/record.url?scp=85161880911&partnerID=8YFLogxK
U2 - 10.1097/ALN.0000000000004574
DO - 10.1097/ALN.0000000000004574
M3 - Article
C2 - 37027803
AN - SCOPUS:85161880911
SN - 0003-3022
VL - 139
SP - 77
EP - 90
JO - Anesthesiology
JF - Anesthesiology
IS - 1
ER -