Supported by: the MRMC, Terumo BCT Biotechnologies.
Primary hemostatic capacity of whole blood: a comprehensive analysis of pathogen reduction and refrigeration effects over time
Version of Record online: 10 JAN 2013
© 2013 American Association of Blood Banks
Special Issue: The THOR Network 2012 Remote Damage Control Resuscitation Symposium
Volume 53, Issue Supplement S1, pages 137S–149S, January 2013
How to Cite
Pidcoke, H. F., McFaul, S. J., Ramasubramanian, A. K., Parida, B. K., Mora, A. G., Fedyk, C. G., Valdez-Delgado, K. K., Montgomery, R. K., Reddoch, K. M., Rodriguez, A. C., Aden, J. K., Jones, J. A., Bryant, R. S., Scherer, M. R., Reddy, H. L., Goodrich, R. P. and Cap, A. P. (2013), Primary hemostatic capacity of whole blood: a comprehensive analysis of pathogen reduction and refrigeration effects over time. Transfusion, 53: 137S–149S. doi: 10.1111/trf.12048
- Issue online: 10 JAN 2013
- Version of Record online: 10 JAN 2013
- Terumo BCT Biotechnologies
Whole blood (WB) has been used in combat since World War I as it is readily available and replaces every element of shed blood. Component therapy has become standard; however, recent military successes with WB resuscitation have revived the debate regarding wider WB use. Characterization of optimal WB storage is needed. We hypothesized that refrigeration preserves WB function and that a pathogen reduction technology (PRT) based on riboflavin and ultraviolet light has no deleterious effect over 21 days of storage.
Study Design and Methods
WB units were stored for 21 days either at 4°C or 22°C. Half of each temperature group underwent PRT, yielding four final treatment groups (n = 8 each): CON 4 (WB at 4°C); CON 22 (WB at 22°C); PRT 4 (PRT WB at 4°C); and PRT 22 (PRT WB at 22°C). Testing was at baseline, Days 1-7, 10, 14, and 21. Assays included coagulation factors; platelet activation, aggregation, and adhesion; and thromboelastography (TEG).
Prothrombin time (PT) and partial thromboplastin time increased over time; refrigeration attenuated the effects on PT (p ≤ 0.009). Aggregation decreased over time (p ≤ 0.001); losses were attenuated by refrigeration (p ≤ 0.001). Refrigeration preserved TEG parameters (p ≤ 0.001) and PRT 4 samples remained within normal limits throughout the study. Refrigeration in combination with PRT inhibited fibrinolysis (p ≤ 0.001) and microparticle formation (p ≤ 0.031). Cold storage increased shear-induced platelet aggregation and ristocetin-induced platelet agglutination (p ≥ 0.032), as well as GPIb-expressing platelets (p ≤ 0.009).
The in vitro hemostatic function of WB is largely unaffected by PRT treatment and better preserved by cold storage over 21 days. Refrigerated PRT WB may be suitable for trauma resuscitation. Clinical studies are warranted.