Abstract
ObjectiveAccording to the international guidelines, fresh frozen plasma (FFP) is unanimously used to treat coagulation disorders. The quality of FFP is critical for the clinical transfusion. Till now, few studies have integratedly evaluated the differences of FFP from blood donors at between high altitude (HA) and low altitude (LA). Besides, there were no special quality standards for HA FFP in China.Materials and methodsUp to 41 HA (Lhasa, 3700 m) and 46 LA (Chengdu, 500 m) blood donors were included in our study to estimate the differences of FFP from HA and LA blood donors. The concentration of total plasma proteins, prothrombin time (PT), activated partial thromboplastin time (aPTT), thrombin time (TT), fibrinogen (Fbg), factor (F) II, FV, FVII, FVIII, FIX, FX, FXI, FXII, D-dimer, protein C (PC), protein S (PS), antithrombin III (ATIII) and von Willebrand factor antigen (vWF:Ag) were determined, respectively.ResultsAs compared with FFP of LA blood donors, the total protein content of HA blood donors showed a significant decrease (65.2±8.9 vs.57.2±6.3 g/L; p<0.001); PT, aPTT, TT were significantly increased (p<0.001); the levels of FII, FV, FVII, FVIII, FIX, FX, FXI, FXII and vWF:Ag were notably decreased (all p<0.05), whereas Fbg and D-dimer were dramaticly increased (p = 0.038). Additionly, in HA blood donors, vWF: Ag and FVIII:C of O-group was significantly lower (p<0.05) than that of non-O-group. It should be noted that FVIII:C of HA blood donors (0.64±0.10 IU/mL) was lower than the current Chinese quality requirements for FFP (≥ 0.7 IU/ml). No significant differences were observed in PC, PS and ATIII.ConclusionIn general, our findings showed that the quality of FFP was significantly different between HA and LA blood donors, and the current Chinese quality requirements of FFP are not suitable for HA FFP. Therefore, setting up a special quality requirement for HA is quite necessary and meaningful.
Highlights
Low ambient temperature and hypobaric hypoxia are two challenges to life at high altitude (HA) [1]
It should be noted that FVIII:C of HA blood donors (0.64±0.10 IU/mL) was lower than the current Chinese quality requirements for Fresh Frozen Plasma (FFP) (! 0.7 IU/ml)
Despite the fact that there is quality requirements for FFP in China (the activity of factor (F) VIII is at least 0.70 IU/mL and the content of total plasma protein is at least 50 g/L [10]), no one knows whether the quality requirement is suitable for HA areas
Summary
Low ambient temperature and hypobaric hypoxia are two challenges to life at high altitude (HA) [1]. As compared with low altitude (LA) residents, people who stay at HA were found with prolonged clotting time, decreased FVIII activities, increased protein C (PC) levels and significantly changed D-Dimer, von Willebrand factor (vWF) activity [3,4,5]. All of these reports indicate that HA may influence the quality of blood products. Despite the fact that there is quality requirements for FFP in China (the activity of factor (F) VIII is at least 0.70 IU/mL and the content of total plasma protein is at least 50 g/L [10]), no one knows whether the quality requirement is suitable for HA areas
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