The effect of thawing fresh frozen plasma at various temperatures on in vitro coagulation factor activity

Abstract

Thawing of fresh frozen plasma (FFP) in South Africa is not standardized and thawing at high temperatures may cause clotting factor activation and disseminated intravascular coagulation (DIC). This research project studies the in-vitro effects of thawing FFP at various temperatures on coagulation. Twenty units of FFP were each divided into 4 satellite bags which were respectively thawed at 22ºC, 37ºC, 45ºC and 60ºC and tested for Fibrinogen, DDimers, PT, PTT, r value, Alpha Angle and Maximum Amplitude (MA). FFP thawed at 60ºC showed significant differences suggesting clotting factor inactivation. FFP thawed at 45ºC showed significantly elevated D-Dimers. Clotting factors thawed at 22ºC may be partially inactivated. High thawing temperatures may activate and then denature the factors therein. Twenty two degrees may partially inactivate FFP until it is warmed to body temperature. The clinical implications and recommendations of this study are to thaw FFP at 37ºC.