More 5 day plasma concerns.

[John C. Staley]

We are struggling to implement a policy for converting FFP to Thawed Plasma with a 5 day out dates. One of the corporate transfusion medical directors is strongly against this idea (not sure why) but her latest stated concerns were "disulfide bond reductase, levels of prothrombin fragment 1 + 2 which are slightly elevated in PHF".

Have any of you heard or read any thing pertaining to either of these and thawed plasma? Any help will be greatly appreciated.

Thanks

John

[BSIPHERD]

When I did a search on disulfide bond reductase, the only thing that I found that might have something to do with transfusion is the following:

A protein disulfide bond reductase in plasma reduces the average multimer size of vWF secreted by endothelial cells. This activity has been isolated from ...

www.jem.org/cgi/content/abstract/193/12/1341 - Similar

[labgirl153]

John, I did a pretty extensive search on relationships between 5-day plasma and the elements your pathologist mentioned and have come up empty on an association or any studies. If she has links or papers then I'd love to see them. Otherwise sounds like she's grasping at straws or is just one of many dinosaurs out there in the blood bank field who refuse positive change. Like you I've read many studies over the years on the pros and cons of a five day expiration and have little problem with it. My facility (a level 2 hospital) just NOW converted to a five day expiration and the techs still have outdated ideas concerning it. (An SBB who works as a generalist on 3rd shift refuses to acknowledge any benefits from it). Fortunately, our new bb manager is not as backwards as this crew (I dare not say where specifically, but it's on the west coast). Hopefully the techs will come around to the idea. I've used 5-day plasma on traumas AND onco patients with good results. If your pathologist can compromise, then why not restrict the use of it to traumas only? or stipulate that kids and oncos receive 24 hour expiration FFP? Good luck on that one.

[Likewine99]

We've been using 5 day plasma for about 2 years, huge savings to the corporation/hospital from not wasting plasma.

For what it's worth, Dr. Disulfide Bond, not to be confused with James Bond, needs to come into the new millenium and realize that this is acceptable BB practice for a majority of FFP recipients.

Again, good luck!!