Preserving the precious: Use of segment drawn at the time of preparation for routine quality control of fresh frozen plasma
Charumathy Arjunan, Dheeraj Khetan, Atul Priyadarshi, Anupam Verma, Rajendra Chaudhary, Priti Elhence, Anup Kumar, Sachin KumarBackground and objectives
Quality control testing of fresh frozen plasma (FFP) requires estimation of unit volume, factor VIII levels, fibrinogen levels, and sterility testing. Sampling from the FFP unit requires thawing of the unit leading to its discard. We investigated if sample taken from segment instead of plasma unit can be used for quality control testing to preserve the plasma unit.
Methods
Cross-sectional study involving 35 FFP units prepared from 450 mL whole blood donations. Segments (∼10 cm) of plasma units were prepared and stored alongside FFP unit. Prothrombin time (PT), activated partial thromboplastin time (APTT), factor V, factor VII, factor VIII, and fibrinogen levels were estimated using automated analyser (STA Satellite, Diagnostica Stago). Segment and bag values were compared (Wilcoxon signed rank test). Simple linear regression was used to derive a mathematical equation for variables with significant differences.
Results
PT (14.6 vs. 14.2 sec), factor VII activity (144.9 vs . 161.2%,) and fibrinogen levels (305.7 vs. 301.9 mg/dL) were comparable in both samples. Significant differences were observed in mean APTT (29.7 vs. 30.7 sec, P =0.04), mean factor VIII activity (216.2% vs. 172.6%, P =0.006) and mean factor V activity (132.3% vs. 104.4%, P =0.011) between the segment and bag samples. Mathematical equation for estimation of bag APTT and factor VIII values from the segment sample was derived using 70% of the sample and successfully validated with remaining 30% sample.
Interpretation and conclusions
With validated equations, for APTT and factor VIII, segment samples can reliably support routine plasma quality control, offering a practical way to reduce plasma discard.