Comparison of solvent/detergent-inactivated plasma and fresh frozen plasmaunder routine clinical conditions

Background: Reduced levels of protein S (PS) and alpha(2)-antiplasmin (alph a(2)-AP) in solvent/detergent virus-inactivated plasma (S/D-VIP) might indu ce an imbalance of plasma coagulation factors and inhibitors in patients tr ansfused. We investigated 40 patients (23 fresh frozen plasma (FFP), 17 S/D -VIP, random distribution by a list calculated by statisticians) who suffer ed from dilution coagulopathy, river disease, disseminated intravascular co agulation (DIC), polytrauma or were connected to extracorporeal circulation . Study Design and Methods: The following markers of activated coagulation (MAC) were measured: Prothrombin fragment F1+2 (F1+2), fibrin monomers (FM) , D-dimers (DD), thrombin-antithrombin (TAT) and plasmin-antiplasmin (PAP) complexes as well as fibrinogen degradation products (FgDP), and additional ly antithrombin III (antithrombin), protein C (PC), PS and alpha(2)-AP. Bro od was taken only just before and 1 h after the first plasma replacement (2 units). No additional blood products were transfused before the second bro od withdrawal. Pre- and posttransfusion (pre/post) values of all parameters measured were compared within the same group and between both groups. Stat istical evaluation of the data was done by Wilcoxon's paired test for data in the same plasma group and by the test of Mann and Whitney for data compa rison between both plasma groups. Results: Average pretransfusion values of all inhibitors for both plasma groups were in the same range and increased after transfusion, except for PS in both groups. Whereas the pre/post valu es did not differ significantly in the FFP group, antithrombin (p = 0.02), PC (p = 0.0005), and alpha(2)-AP (p = 0.02) showed a significantly higher i ncrease in the S/D-VIP group. Considering the pre/post differences between both plasma groups, there were no significant differences. The same was tru e for MAC measured pre- and posttransfusion. Conclusion: Data showed no sig nificant difference between both plasma groups, indicating that S/D-VIP pla sma behaves as FFP under the study conditions employed.