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 Table of Contents  
COMMENTARY
Year : 2020  |  Volume : 5  |  Issue : 1  |  Page : 115-116

Fresh frozen plasma: A new perspective


Department of Pathology, Sri Devaraj Urs Medical College, Kolar, Karnataka, India

Date of Submission28-Sep-2019
Date of Decision12-Dec-2019
Date of Acceptance18-Dec-2019
Date of Web Publication17-Apr-2020

Correspondence Address:
Subhashish Das
Department of Pathology, Sri Devaraj Urs Medical College, Kolar, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/GJTM.GJTM_60_19

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How to cite this article:
Das S. Fresh frozen plasma: A new perspective. Glob J Transfus Med 2020;5:115-6

How to cite this URL:
Das S. Fresh frozen plasma: A new perspective. Glob J Transfus Med [serial online] 2020 [cited 2020 Nov 26];5:115-6. Available from: https://www.gjtmonline.com/text.asp?2020/5/1/115/282740



With reference to the article “Loganathan R, Kulkarni RG, Kar R, Abhishekh B, Basu D. Assessment and association of coagulation factors (FVIII and fibrinogen) with the mode of collection and storage of fresh frozen plasma (FFP). Glob J Transfus Med 2019;4:204-7,” I have the following opinion to be shared.

Preanalytical conditions in laboratory assessment of coagulation systems and hemostasis are very important.[1] Preanalytical variables which can effect coagulating test and factor analysis results are specimen collection, hematocrit, transportation, filling status of the sampling tube, centrifuge, anticoagulant type and concentration, as well as storage and assay method.[2]

Many studied have suggested acceptable storage temperature for routine coagulation test.[3] Although the variable influences of storage, temperature and time on Factor IX and Factor VIII in FFP have been reported.[4]

To diagnose and treat hemophilia and to monitor oral anticoagulation therapy, thrombotic disease, and chronic liver disease, timely and accurate coagulation tests and factor detection in fresh plasma samples are very important.[5]

To analyze the effect of plasma storage and study on factor VIII and fibrinogen, several studies have been done. Kemkes Matthes et al. have reported that the acceptable time interval for the storage of APTT, activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), fibrinogen, and D dimer after storage for 8 hours at room temperature which can be extended to 24 hours for PT, TT, and D dimer determination. Van Geest Daalderop et al. have reported that the acceptable time interval is 6 hours at 4–6°C, for PT/INR determination. Rao LV et al.[6] have reported that whole blood and plasma samples can be tested for APTT for up to 12 h and for PT for up to 24 h, when transported either at room temperature or at 4°C.[7]

In clinical practice, coagulation tests and factor measurements have been widely applied. Therefore, it is necessary to evaluate the effects of time from collection and temperature on the outcome of these results. The plasma samples tested could be safely stored for up to 24 h both at 4°C and 25°C for fibrinogen, PT/INR, and TT determination; those tested for APTT measurement could be safely stored for 12 h at 4°C and 8 h at 25°C; those tested for FIX: C measurement could be safely stored for 4 h at 4°C and 25°C; and measurement of FVIII-C should be done immediately that is within 2 h after collection in our laboratory. Thus, clinical samples should only be stored for these time frames before testing.[8]



 
  References Top

1.
Lippi G, Guidi GC, Mattiuzzi C, Plebani M. Preanalytical variability: The dark side of the moon in laboratory testing. Clin Chem Lab Med 2006;44:358-65.  Back to cited text no. 1
    
2.
Zhao Y, Lv G. Influence of temperature and storage duration on measurement of activated partial thromboplastin time, D-dimers, fibrinogen, prothrombin time and thrombin time, in citrate-anticoagulated whole blood specimens. Int J Lab Hematol 2013;35:566-70.  Back to cited text no. 2
    
3.
Loeliger EA, van den Besselaar AM, Lewis SM. Reliability and clinical impact of the normalization of the prothrombin times in oral anticoagulant control. Thromb Haemost 1985;53:148-54.  Back to cited text no. 3
    
4.
Mulder R, van Schouwenburg IM, Mahmoodi BK, Veeger NJ, Mulder AB, Middeldorp S, et al. Associations between high factor VIII and low free protein S levels with traditional arterial thrombotic risk factors and their risk on arterial thrombosis: Results from a retrospective family cohort study. Thromb Res 2010;126:e249-54.  Back to cited text no. 4
    
5.
Kemkes-Matthes B, Fischer R, Peetz D. Influence of 8 and 24-h storage of whole blood at ambient temperature on prothrombin time, activated partial thromboplastin time, fibrinogen, thrombin time, antithrombin and D-dimer. Blood Coagul Fibrinolysis 2011;22:215-20.  Back to cited text no. 5
    
6.
van Geest-Daalderop JH, Mulder AB, Boonman-de Winter LJ, Hoekstra MM, van den Besselaar AM. Preanalytical variables and off-site blood collection: Influences on the results of the prothrombin time/international normalized ratio test and implications for monitoring of oral anticoagulant therapy. Clin Chem 2005;51:561-8.  Back to cited text no. 6
    
7.
Oddoze C, Lombard E, Portugal H. Stability study of 81 analytes in human whole blood, in serum and in plasma. Clin Biochem 2012;45:464-9.  Back to cited text no. 7
    
8.
Rao LV, Okorodudu AO, Petersen JR, Elghetany MT. Stability of prothrombin time and activated partial thromboplastin time tests under different storage conditions. Clin Chim Acta 2000;300:13-21.  Back to cited text no. 8
    




 

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