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- Title
Spray-dried plasma deficient in high-molecular-weight multimers of von Willebrand factor retains hemostatic properties.
- Authors
Meledeo, Michael Adam; Liu, Qiyong Peter; Peltier, Grantham C.; Carney, Ryan C.; McIntosh, Colby S.; Taylor, Ashley S.; Bynum, James A.; Pusateri, Anthony E.; Cap, Andrew P.
- Abstract
<bold>Background: </bold>Dried plasmas can overcome logistical barriers that prevent fresh frozen plasma (FFP) usage in acute resuscitation, but processing of these products can detrimentally alter the composition. Spray-dried plasma (SpDP) from single units is deficient in high-molecular-weight multimers of von Willebrand factor (vWF), a critical facilitator of platelet adhesion and thrombus formation. We hypothesized that converting high-molecular-weight multimers to smaller-molecular-weight multimers would retain vWF's capacity to mediate platelet adhesion.<bold>Study Design and Methods: </bold>SpDP obtained from untreated FFP was reconstituted with glycine-hydrochloric acid (HCl) and glycine (20 mM:50 mM) or pretreated with glycine-HCl (20 mM) or glycine-glycine-HCl (20 mM:50 mM) and reconstituted with water. In vitro hemostatic potential of SpDPs versus FFP or FFP spiked with 70 mM of glycine was evaluated, leading to a more detailed in vitro study of glycine-HCl-glycine (20 mM:50 mM) pretreated SpDP. Plasmas were combined with RBCs and platelets to observe global coagulation response.<bold>Results: </bold>While vWF-ristocetin cofactor activity is significantly decreased (-41.13%; p < .0001) in SpDP, a model of vWF-mediated platelet adhesion to collagen under flow showed enhanced function (+13%; p < .01). Fewer microparticles, particularly of platelet origin, were observed in SpDP versus FFP (p < .0001). Small but significant differences in thromboelastography results were observed, although SpDP and FFP were within normal ranges.<bold>Conclusion: </bold>Comparable coagulability was observed in FFP and SpDP. The apparent paradox between vWF-ristocetin cofactor assay and vWF-mediated platelet adhesion may be explained by the increase in smaller multimers of vWF in SpDP, producing different outcomes in these assays.
- Subjects
ROYAL Bank of Canada; VON Willebrand factor; PLASMA gases; GLYCINE; ADHESION
- Publication
Transfusion, 2019, Vol 59, Issue 2, p714
- ISSN
0041-1132
- Publication type
journal article
- DOI
10.1111/trf.15038