Transfusion最新文献

{"title":"Low-titer group O whole blood implementation in a tertiary care hospital in Estonia.","authors":"Riin Kullaste, Marika Pikta, Mari Loot, Stanislava Russakova, Eve Laansoo, Kadri Rohtla, Gulara Khanirzajeva, Ene Vadi, Dina Ljahh","doi":"10.1111/trf.18137","DOIUrl":"10.1111/trf.18137","url":null,"abstract":"<p><p>The implementation of the use of low titre group O whole blood in the North Estonia Medical Centre took place in a little more than 2 years. It began with the creation of a low-titer O+ male donor registry, included a pilot project with a limited number of patients, validation of whole blood as a new product, and also required a change in the Estonian law. Today, whole blood is in routine use in emergency patients of both sexes and all ages with life-threatening bleeding. Among the indications, gastro intestinal bleeding comes first, followed by acute blood loss associated with trauma. Whole blood is also included in the massive transfusion protocol.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"S237-S239"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nationwide estimates of potential lives saved with prehospital blood transfusions.","authors":"Daniel T Lammers, Richard Betzold, Reynold Henry, Joshua Dilday, Jeffrey R Conner, James M Williams, John M McClellan, Matthew J Eckert, Jan O Jansen, Jeffrey Kerby, John B Holcomb, Zain G Hashmi","doi":"10.1111/trf.18174","DOIUrl":"10.1111/trf.18174","url":null,"abstract":"<p><strong>Introduction: </strong>Prehospital blood transfusions result in a significant reduction in mortality risk for injured patients in hemorrhagic shock; however, prehospital blood transfusions have not been widely implemented across the United States. Thus, a paucity of data surrounding the impact of achieving near-complete population-level access to this resource exists. We aimed to determine the number of lives that could potentially have been saved among injured patients in hemorrhagic shock between 2020 and 2023 had prehospital blood products (blood components or whole blood, pBP) been fully implemented.</p><p><strong>Methods: </strong>We performed a retrospective review of the National Emergency Medical Services Information System (NEMSIS) from 2020 to 2023 for all trauma patients ≥16 years. Patients with prehospital systolic blood pressure <90 mmHg and heart rate >108 beats per minute, or a systolic blood pressure <70 mmHg, and who did not receive pBP products were included in the analysis. Potential lives saved were calculated using mortality and risk ratio estimates (RR) from previously published studies, assuming 100% nationwide access to pBP. A series of models were developed incorporating varying RR, mortality rate assumptions, and nationwide access to pBP to encompass a wide range of scenarios.</p><p><strong>Results: </strong>A total of 260,472 patients met our inclusion criteria. Using a 22.1% 24-h mortality rate and an RR of 0.629, 21,356 deaths over the four-year study period could have potentially been saved with the nationwide implementation of pBP.</p><p><strong>Conclusion: </strong>Transfusion of pBP offers the potential to save thousands of injured patients lives. Efforts toward making policy-level interventions aimed at increasing the adoption and availability of pBP should be sought.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"S14-S22"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Partial REBOA Zone 1 is associated with lower mortality compared to complete REBOA Zone 1 and emergency department thoracotomy: A cohort study using the AORTA registry.","authors":"Morgan G Dewey, Ernest E Moore, Lee Anne Ammons, Isabella M Bernhardt, Angela Sauaia, Meghan L Brenner","doi":"10.1111/trf.18177","DOIUrl":"10.1111/trf.18177","url":null,"abstract":"<p><strong>Background: </strong>Resuscitative endovascular balloon occlusion of the aorta (REBOA) and emergency department thoracotomy (EDT) are effective methods of aortic occlusion (AO) for life-threatening bleeding; however, complete AO can lead to visceral ischemia. Partial REBOA (P-REBOA) has been proposed as an alternative to the completely occlusive REBOA (C-REBOA) to balance hemorrhage control and perfusion. Using the Aortic Occlusion for Resuscitation in Trauma (AORTA) multicenter, observational registry, we tested the hypothesis that P-REBOA resulted in better outcomes compared to EDT and C-REBOA.</p><p><strong>Study design and methods: </strong>We queried the 2017-2023 AORTA registry for adults who underwent EDT, C-REBOA, or P-REBOA in the emergency department (ED). Patients with chest penetrating injuries were excluded. We compared mortality, ventilator-free-days (VFD), and ICU-free-days (ICUFD) using survival analysis or generalized linear models to adjust for confounders.</p><p><strong>Results: </strong>Overall, 921 patients underwent EDT (n = 613, 66.6%), C-REBOA (n = 224, 24.3%), or P-REBOA (n = 84, 9.1%); 83.1% died. After confounder adjustment, compared to P-REBOA, both C-REBOA and EDT were associated with a lower likelihood of attaining hemodynamic improvement and stability as well as with higher mortality (adjusted hazard ratio, aHR = 1.84; 95% CI: 1.01-1.60 and aHR = 3.32; 95% CI: 1.96-2.78, respectively). EDT patients had less VFD and ICUFD than those undergoing C-REBOA and P-REBOA, but there were no differences between the two endovascular procedures. Among patients who survived >48 h, EDT was more likely to be associated with complications compared to the other two procedures.</p><p><strong>Discussion: </strong>P-REBOA was more likely to be associated with improved hemodynamic stability and reduced mortality compared to C-REBOA and EDT, suggesting this modality may be a better AO procedure for patients with no penetrating thoracic injuries.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"S80-S97"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of oxygen extraction rate changes following red blood cell transfusion in the intensive care unit: A prospective observational noninterventional study.","authors":"Ahmet Salih Tüzen, Murat Aksun, Atilla Şencan, Senem Girgin, Birzat Emre Gölboyu, Gizem Kırbaş, Ozan Şanlı","doi":"10.1111/trf.18164","DOIUrl":"10.1111/trf.18164","url":null,"abstract":"<p><strong>Background: </strong>The decision-making process for red blood cell transfusion (RBCT) in critically ill patients in the intensive care unit (ICU) remains primarily guided by hemoglobin-based thresholds. However, as a component of personalized medicine, innovative and individualized criteria should be developed to optimize RBCT decisions. This study aims to assess the impact of RBCTs on oxygenation parameters and patient outcomes, with a specific focus on the oxygen extraction ratio (O₂ER).</p><p><strong>Study design and methods: </strong>This prospective observational study included 77 critically ill patients receiving RBCTs according to ICU transfusion protocols. The primary hypothesis is that patients with an O₂ER > 0.30 will benefit most from RBCTs. To investigate this, patients receiving RBCTs were divided into two groups: those with O₂ER > 0.30 (RBCTs appropriate) and those with O₂ER ≤ 0.30 (RBCTs appropriateness questionable). The two groups were compared in terms of primarily O₂ER, other oxygenation parameters, and clinical outcomes. The primary outcome was the change in O₂ER following RBCTs, while secondary outcomes encompassed other oxygenation parameter changes.</p><p><strong>Results: </strong>The O₂ER > 0.30 group showed significant improvement in O₂ER (0.38 ± 0.04 vs. 0.32 ± 0.05; p < .001), whereas no such improvement was observed in the O₂ER ≤ 0.30 group (0.26 ± 0.03 vs. 0.28 ± 0.05; p: .017). Additionally, the O₂ER > 0.30 group exhibited improvements in central venous oxygen saturation (ScvO₂) following RBCTs, which were not seen in the O₂ER ≤ 0.30 group.</p><p><strong>Discussion: </strong>Our study reveals promising insights into the impact of RBCTs on O₂ER; however, these physiological changes did not result in significant clinical improvements. Hence, this study provides a rational basis for the feasibility of implementing a personalized strategy focused on physiological triggers for RBCTs.</p><p><strong>Trial registration number: </strong>NCT05798130 (https://clinicaltrials.gov/study/NCT05798130).</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"863-875"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low rate of hepatitis Delta virus co-infection in first-time blood donors diagnosed with chronic hepatitis B virus infection in the Netherlands.","authors":"Thijs J W van de Laar, Lesley A Patmore, Michel M Molier, Milan J Sonneveld, Jolanda J C Voermans, Ed Slot, Mariet C W Feltkamp, Annemiek A van der Eijk, Hans L Zaaijer","doi":"10.1111/trf.18238","DOIUrl":"10.1111/trf.18238","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis Delta virus (HDV) requires co-infection with hepatitis B virus (HBV) and increases the risk of hepatitis-related morbidity and mortality compared to HBV mono-infection. HBV/HDV co-infected patients will likely benefit from new HDV antiviral drugs, but reliable estimates of co-infection rates are lacking due to limited HDV testing of HBV-infected patients.</p><p><strong>Study design and methods: </strong>First-time blood and bone tissue donors in the Netherlands (2006-2023) with a newly diagnosed chronic HBV infection were retrospectively tested for HDV antibodies, and for HDV RNA if HDV antibodies were detected. HBV genotyping using phylogenetic analysis was performed to determine the most likely origin of HBV infection.</p><p><strong>Results: </strong>HBV-DNA was detected in 254/758.081 (0.034%) first-time donors in the Netherlands. HBsAg-positive first-time donors had a median age of 43 years (IQR: 33-52), were predominantly male (67%), mostly first- or second-generation migrants (76%) and HBV (sub)genotype strongly correlated with the country of birth. HDV testing was performed for 200 first-time donors with chronic (HBsAg-positive) HBV infection: 5 donors (2.5%) had HDV antibodies, and 1 donor (0.5%) also had detectable HDV RNA. None of the 17 donors with occult (HBsAg-negative) HBV infection had experienced HDV infection.</p><p><strong>Discussion: </strong>Chronic HBV/HDV co-infection in first-time donors in the Netherlands is extremely rare, affecting 0.00013% of all first-time donors, and only 0.5% of HBsAg-positive first-time donors consisting predominantly of migrants from high(er) HDV-endemic countries. Despite low HBV/HDV co-infection rates, a one-time HDV reflex testing strategy for HBsAg-positive patients remains essential to identify patients and to initiate antiviral treatment if needed to reduce the risk of serious liver disease.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"841-847"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing direct transfusion feasibility with syringe-based collection of whole blood from universal donors.","authors":"Chet Voelker, Grantham Peltier, Nichelle Crenshaw, Michael Meledeo, Andrew Cap, Nicholas Studer","doi":"10.1111/trf.18154","DOIUrl":"10.1111/trf.18154","url":null,"abstract":"<p><strong>Background: </strong>The anticipated multidomain operations of future battlefields necessitates minimalistic medical strategies for treatment of combat wounded. Direct transfusion, involving the administration of blood directly from a donor to a recipient, may be a solution for treating hemorrhagic shock patients in an austere environment where the tools to execute clinical practice guidelines are unavailable.</p><p><strong>Study design and methods: </strong>Six participants were enrolled in this observational pilot study. Blood was drawn through medical tubing using a 60 mL syringe and pushed through a second medical tubing set with output to a waste container. Three participants were collected with untreated lines, and three collections were performed with heparin flushed lines. Visible clotting was assessed, and blood samples were collected from the output at baseline, after 240 mL of blood collected, and at study endpoint, which was 400 mL collection or termination due excessive clotting or draw difficulties. Coagulation, hematology, and chemistry testing were performed on the samples.</p><p><strong>Results: </strong>Visible clotting was observed at endpoint in the four procedures with the longest draw times. There were statistically significant differences in platelet count and fibrinogen concentration between baseline and endpoint samples of the non-heparin group. Clot strength decreased over time in the non-heparin group.</p><p><strong>Discussion: </strong>The association between longer procedure times and visible clotting indicates direct transfusions should be completed based on time constraints rather than target volumes. Maintenance of platelet count, fibrinogen concentration, and clot strength in the heparin group suggest that heparin coated lines may enhance the safety of direct transfusions.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":"65 Suppl 1 ","pages":"S63-S67"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HIV incidence in US first-time blood donors during 12 and 3 month deferral policy periods between 2015 and 2023 before implementation of individual donor assessment.","authors":"Eduard Grebe, Clara Di Germanio, Edward P Notari, Mars Stone, Jahnavi Reddy Bhaskar, Venkata Dayana, Marion C Lanteri, Jed Gorlin, Rita Reik, Susan L Stramer, Michael P Busch, Benyam Hailu, Artur A Belov, Hong Yang, Barbee Whitaker, Brian Custer","doi":"10.1111/trf.18195","DOIUrl":"10.1111/trf.18195","url":null,"abstract":"<p><strong>Background: </strong>Following FDA guidance, US blood collectors changed donor deferral for men who have sex with men (MSM) from indefinite to a 12 month deferral in 2016 (12 m), and for MSM and several other exposure risks to 3 month deferrals in 2020 (3 m). We evaluated first-time donor (FTD) HIV incidence and demographics during these periods.</p><p><strong>Study design and methods: </strong>We estimated cross-sectional HIV incidence and incidence rate differences in FTD based on routine donation nucleic acid testing (NAT) and serology with additional limiting antigen (LAg)-Avidity immunoassay and viral load testing. We estimated incidence in the two policy periods (12 and 3 m), incidence trends in two-year intervals between 2015 and 2023, and used multivariable Poisson regression to assess demographic correlates of incident infection.</p><p><strong>Results: </strong>HIV incidence in FTD during the 12 m deferral period was 2.82 infections/10⁵ person-years (PY) [95% CI: 2.12, 3.67] and during the 3 m deferral period, it was 1.88/10⁵ PY (95% CI: 1.18, 2.67), a statistically significant decline (p < .05). Over the period 2015-2023, incidence was stable. Male sex, younger age, Black or African American race, Hispanic ethnicity, and residence in the South were associated with incident infection in regression analysis, but the time-based deferral policy periods were not.</p><p><strong>Discussion: </strong>HIV incidence in FTD did not increase between 2015 and 2023. An overall decline in HIV incidence in the 3 m deferral period compared with the 12 m deferral period was evident. These results provide no indication of an increased residual risk of transfusion-transmitted HIV from FTD in the United States with the reduced deferral periods.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"834-840"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of prehospital chest decompression in resolving clinical signs of tension pneumothorax.","authors":"Tomer Talmy, Dean Lichter, Cole D Bendor, Irina Radomislensky, Avishai M Tsur, Ofer Almog","doi":"10.1111/trf.18199","DOIUrl":"10.1111/trf.18199","url":null,"abstract":"<p><strong>Background: </strong>Thoracic injuries are a leading cause of morbidity and mortality in military trauma. Tension pneumothorax (TPX) is a critical diagnosis that can lead to rapid hemodynamic and respiratory collapse if untreated. While timely intervention is essential, prehospital TPX diagnosis is challenging and may lead to unnecessary interventions. This study aimed to assess military prehospital chest injury management, including indications for chest decompression and clinical improvement post-intervention.</p><p><strong>Study design and methods: </strong>Retrospective analysis of the Israel Defense Forces (IDF) Trauma Registry from January 2010 to August 2023 identifying patients who underwent needle or chest tube decompression. Data included demographics, injury mechanisms, vital signs, additional interventions, and prehospital mortality. Chart review evaluated decompression indications and outcomes, with the primary outcome being resolution of decreased oxygen saturation, tachycardia, or hypotension post-decompression.</p><p><strong>Results: </strong>Overall, 224 patients were included, with a median age of 22 years. The most common injury mechanisms were gunshots (36.6%) and motor vehicle accidents (34.4%). Needle chest decompression was performed in 58.5% of cases, chest tubes in 12.5%, and both in 29.0%. Indications included traumatic cardiac arrest (53.1%), profound shock (17.9%), and SpO₂ < 85% (13.8%). In 15.2% of cases, decompression did not meet the IDF guideline criteria. Only three cases (1.3%) showed resolution of tachycardia, hypotension, or low oxygen saturation. In five cases, vital signs briefly returned after traumatic cardiac arrest, but none survived to hospital admission.</p><p><strong>Discussion: </strong>Chest decompression may be overutilized in prehospital military trauma. Future studies should refine criteria to optimize benefits while minimizing iatrogenic risks.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"S103-S112"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How I do it: An institutional protocol for the management of RhD negative women who receive RhD positive blood.","authors":"Rahaf Alkhateb, Kirea Mazzolini, Vipulkumar Pravinbhai Prajapati, Chantal Harrison, Kayla E Ireland, Donald Jenkins, John Daniels, Leslie Greebon","doi":"10.1111/trf.18181","DOIUrl":"10.1111/trf.18181","url":null,"abstract":"<p><strong>Background: </strong>RhD alloimmunization can result from blood transfusion or fetomaternal hemorrhage (FMH). Preventing alloimmunization in childbearing-age women with FMH via utilization of RhD immunoglobulin (RhIG) is well known; however, there are no established protocols for RhD-mismatched transfusions in emergent or traumatic settings. Here, we describe our hospital protocol for managing RhD negative women who receive RhD positive transfusions.</p><p><strong>Design: </strong>Pathology or Transfusion Medicine staff are notified of RhD-mismatched blood transfusions. Women with childbearing potential are evaluated by Obstetrics and Gynecology (ObGyn) to determine patients' childbearing desires and physical capabilities, as well as their ability to tolerate RhIG administration. Pathologists determine eligibility for therapy with RhIG: criteria include RhD negative females, <50 years old, without current or historical Anti-D, who have been transfused <20% of their total blood volume (TBV) with RhD positive blood.</p><p><strong>Results: </strong>Management strategy depends on red blood cell volume (RBCv) transfused. Patients who receive an RBCv ≤20% of their TBV are eligible to receive RhIG, while an RBCv >20% makes individuals ineligible for prophylaxis with RhIG. Red cell exchange (RCX) is not offered at our institution, regardless of RBCv transfused. Women who receive RhIG should be screened for the development of antibodies using direct and indirect antiglobulin tests for 6-12 months posttransfusion. Future pregnancies of alloimmunized women should be carefully monitored.</p><p><strong>Conclusion: </strong>Our therapeutic plan involves identifying eligible patients based on set criteria. This is the first published protocol to prevent RhD alloimmunization in females of childbearing age due to RhD-mismatched transfusions.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"S320-S327"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Freeze-dried plasma: Hemostasis and biophysical analyses for damage control resuscitation.","authors":"Aron A Shoara, Kanwal Singh, Henry T Peng, Katy Moes, Jeong-Ah Yoo, Sahar Sohrabipour, Sanewal Singh, Rex Huang, Peter Andrisani, Chengliang Wu, Katerina Pavenski, Paul Y Kim, Bernardo Trigatti, Colin A Kretz, Ori D Rotstein, Shawn G Rhind, Andrew N Beckett","doi":"10.1111/trf.18124","DOIUrl":"10.1111/trf.18124","url":null,"abstract":"<p><strong>Background: </strong>Effective hemorrhage protocols prioritize immediate hemostatic resuscitation to manage hemorrhagic shock. Prehospital resuscitation using blood products, such as whole blood or alternatively dried plasma in its absence, has the potential to improve outcomes in hemorrhagic shock patients. However, integrating blood products into prehospital care poses substantial logistical challenges due to issues with storage, transport, and administration in field environments.</p><p><strong>Study design and methods: </strong>We utilized hemostatic assays and advanced biophysical techniques, such as calorimetry, infrared spectoscopy, dynamic light scattering, and biolayer interferometry, to compare the functional and structural properties of freeze-dried plasma (FDP; OctaplasLG Powder, Octapharma AB) with those of fresh plasma controls.</p><p><strong>Results: </strong>Hemostatic characterization of FDP revealed that clot formation properties and coagulation parameters were largely comparable to fresh plasma controls, with some variations observed in Von Willebrand factor-ADAMTS13 axis and fibrinolysis. No change to moisture content of FDP (~1% water content) was observed after 6-month storage at ambient conditions. Biophysical analyses of FDP during transfusion demonstrated spontaneous exothermic mixing of FDP in plasma, a dilution effect from saline, as well as comparable stability to plasma controls. Quantification of ligand-binding affinities of platelet receptors activated GPIIbIIIa and GPIbα showed comparable binding properties to plasma controls.</p><p><strong>Conclusion: </strong>Our results show that FDP exhibits hemostatic functionality and protein stability on par with fresh plasma, as assessed by novel, highly sensitive techniques. FDP therefore represents a viable alternative to conventional plasma in damage control resuscitation, offering significant logistical and storage advantages for prehospital and remote applications, especially in scenarios where whole blood is unavailable.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":"S250-S264"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}