The Stability of Coagulation Factors in Stored Blood

Abstract

AbstractThe relative stabilities of a number of coagulation factors (platelets and platelet function tests, Quick prothrombin activity, labile factor, serum prothrombin conversion accelerator, prothrombin, thromboplastin generation, antihemo¬philic factor, and plasma thromboplastin component) were studied, in whole blood collected into Acid-Citrate-Dextrose, ethylenediaminetetraacetate, and through an ion exchange column, and stored under routine blood banking con¬ditions. The majority of the factors studied remained present in significant amounts during the first ten days of storage in ACD, while some, such as platelets, lasted for longer periods, and others, such as antihemophilic factor, lasted for shorter periods. The rapid decline of labile factor apparently contributed to the initial rapid phase of Quick prothrombic activity loss during the first week of storage, while the less rapid loss of the next two weeks probably was due to the relative stability of serum prothrombin conversion accelerator and prothrombin. The rapid loss of thromboplastin generation ability apparently was correlated with the instability of antihemophilic factor (and associated with the decline of labile factor), whereas the stability of plasma thromboplastin component probably accounts for the slower fall of thromboplastin generation in the second two weeks of storage.The coagulation factors in blood collected into plastic bags with ACD did not appear to be more stable than those in blood collected into glass bottles with ACD; platelet concentrations were higher in the plastic bags, however. The duration of stability of almost all the factors was markedly shortened in blood collected into EDTA and through an ion exchange column; a great loss occurred immediately upon collection. It appears that EDTA and ion exchange blood, in their present forms, have certain deficiencies in the concentration of certain coagulation factors which render them less desirable than ACD blood for use in clinical transfusion, even when freshly drawn. The addition of a phosphate buffer to ion exchange blood, reported to prolong the viability of red blood cells, appeared to interfere with antihemophilic factor activity in vitro.