ANAPHYLATOXINS IN FRESH-FROZEN PLASMA

BACKGROUND: Fresh-frozen plasma (FFP) is widely used in patients with coagulation disorders and simultaneous complement activation. Compleme nt activation in FFP itself is poorly investigated. STUDY DESIGN AND M ETHODS: The concentration of anaphylatoxins C3a and C5a, the complemen t precursors C1q and factor B, and complement function were measured i n 40 consecutively administered FFP units in two pediatric neonatal in tensive care units. In 12 samples, the measurements were also performe d after incubation with inulin. RESULTS: In 15 of 40 FFP units, both a naphylatoxin concentrations were below the upper cutoff levels reporte d for healthy humans (C3a, 500 mu g/L; C5a, 5 mu g/L). Anaphylatoxin l evels were higher in FFP units produced by apheresis than in those fro m blood donation. Complement activation of FFP by inulin increased ana phylatoxin concentration, whereas Clq and factor B levels, and complem ent function remained unchanged. CONCLUSION: Elevated concentrations o f anaphylatoxin are frequently found in FFP units produced by apheresi s. Studies are necessary to investigate the masons for complement acti vation and the possibilities of prevention during apheresis. As the co ncentrations of complement precursors and complement function did not change with activation in FFP, these studies should include measuremen t of the anaphylatoxins C3a and C5a.