Blood Transfusion - 1 2016 (January - February)
Thrombin generation, ProC®Global, prothrombin time and activated partial thromboplastin time in thawed plasma stored for seven days and after methylene blue/light pathogen inactivation
Authors:  Thomas Thiele, Gregor Hron, Sarah Kellner, Christina Wasner, Antje Westphal, Theodore E. Warkentin, Andreas Greinacher, Kathleen Selleng
Pages:  66-72
To cite this article:  Blood Transfus 2016; 14: 66-72
Doi:  10.2450/2015.0030-15
Published online:  09/07/2015

Background. Methylene blue pathogen inactivation and storage of thawed plasma both lead to changes in the activity of several clotting factors. We investigated how this translates into a global loss of thrombin generation potential and alterations in the protein C pathway.
Materials and methods. Fifty apheresis plasma samples were thawed and each divided into three subunits. One subunit was stored for 7 days at 4 °C, one was stored for 7 days at 22 °C and one was stored at 4 °C after methylene blue/light treatment. Thrombin generation parameters, ProC®Global-NR, prothrombin time and activated partial thromboplastin time were assessed on days 0 and 7.
Results. The velocity of thrombin generation increased significantly after methylene blue treatment (increased thrombin generation rate; time to peak decreased) and decreased after storage (decreased thrombin generation rate and peak thrombin; increased lag time and time to peak). The endogenous thrombin generation potential remained stable after methylene blue treatment and storage at 4 °C. Methylene blue treatment and 7 days of storage at 4 °C activated the protein C pathway, whereas storage at room temperature and storage after methylene blue treatment decreased the functional capacity of the protein C pathway. Prothrombin time and activated partial thromboplastin time showed only modest alterations.
Discussion. The global clotting capacity of thawed plasma is maintained at 4 °C for 7 days and directly after methylene blue treatment of thawed plasma. Thrombin generation and ProC®Global are useful tools for investigating the impact of pathogen inactivation and storage on the clotting capacity of therapeutic plasma preparations.

Keywords: methylene blue, thawed plasma, thrombin generation, ProC®Global.
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