Thrombin Generation Capacity of Methylene Blue-Treated Plasma Prepared by the Theraflex MB Plasma System

Abstract

Background: Methylene blue (MB) / light treatment is a well-known procedure for the inactivation of pathogens in fresh frozen plasma (FFP). Aim of the current study was to investigate the thrombin generation (TG) characteristics and quality of MB plasma prepared by the Theraflex MB Plasma System. Methods: Single donor plasma units (n = 18) were MB/light-treated, with sampling before and after processing. Preparation included leukocyte depletion, addition of MB pill prior to illumination, and depletion of MB and photoproducts by filtration. Different plasma parameters and TG were measured. TG additionally was determined in solvent/detergent plasma (n = 8). Results: MB/light treatment significantly affected factors V, VIII and XI, which were decreased by 9–18%. While the antigen level was not affected, fibrinogen according to Clauss was decreased by 7%, correlating with a 12% prolongation of TT and RT. The total amount of free thrombin generated, given as ‘area under the curve’ (AUC), was comparable for untreated (93 ± 18% of normal plasma) and MB/light-treated plasma (95 ± 20%). Also peak thrombin concentration was not significantly affected by treatment (94 ± 11% (untreated) vs. 96 ± 12% (treated)). The ‘time to peak’ value (TTP) was 105% of normal plasma for untreated FFP and 89% for MB-treated plasma. Conclusion: For plasma treated with the Theraflex MB Plasma System no profound influence of MB/ light treatment on the characteristics of thrombin generation was detected. In concordance with data from the literature, coagulation factors V, VIII and XI were decreased due to MB/ light treatment. Decrease was less than 20%.