Rapid thawing of fresh frozen plasma with a 45°C dry tempering system maintains critical coagulation activities.

Abstract

Background: The ability to rapidly transfuse similar volumes of fresh frozen plasma (FFP) and packed red blood cells can reduce mortality in patients with critical bleeding. This is a compelling reason to thaw FFP quickly in real-world clinical practice. A new dry tempering system thaws FFP between two aluminum panels that are maintained at a specific temperature. The FP-2000 (for two bags) and FP-4000 (for four bags) thaw FFP at 37°C (Dry NORMAL mode) and 45°C (Dry EXPRESS mode).

Study design and methods: We compared FFP thawed in a conventional water bath with FFP thawed by dry tempering at 37°C and 45°C, with particular attention to thawing speed, subsequent coagulation factor activity, and evidence of precipitation or denaturation of proteins.

Results: Dry tempering can thaw FFP without bag damage or risks associated with contaminated water. Dry EXPRESS mode at 45°C could thaw FFP as fast as a water bath and had significantly shorter thawing durations than Dry NORMAL mode at 37°C for 240 mL and 480 mL bags. Moreover, both Dry EXPRESS mode and Dry NORMAL mode maintained coagulation factor activities in thawed FFP, with no evidence of protein precipitation or denaturation.

Discussion: Dry tempering is useful for thawing FFP in real-world clinical situations. In contrast to open water baths, dry tempering systems could be incorporated into ambulance and emergency response vehicles responding to traumatic bleeding events. Uniquely, the new dry tempering system at 45°C could save precious minutes in a massive transfusion protocol while preserving FFP coagulation activity.