fibrinopeptide-a and acid-citrate-dextrose

Donor blood, primarily anticoagulated by acid citrate dextrose formula A (ACD-A), was separated by means of the HemaScience Autopheresis C plasmapheresis device. The citrated plasma was collected directly into a solution of heparin and calcium chloride to achieve a final plasma-ionised calcium concentration of approximately 2 mM, and a heparin concentration of 1.0 IU/ml. Heparin at this concentration provided adequate anticoagulation, and did not result in insoluble cryoprecipitates. Three pairs of donor-matched 4-kg plasma pools (anticoagulant-exchanged variant and ACD-A-anticoagulated control) were constructed and subsequently fractionated to an intermediate stage. The mean recovery of factor VIII from 3 anticoagulant-exchanged pools (394 IU/kg) was 23% greater than the mean recovery from the matched control pools (319 IU/kg). This increased recovery was not achieved at the expense of specific activity.

Topics: Anticoagulants; Calcium; Citric Acid; Factor VIII; Fibrin Fibrinogen Degradation Products; Fibrinopeptide A; Fibrinopeptide B; Glucose; Heparin; Humans; Peptide Fragments; Plasmapheresis

This study deals with the question of how blood coagulation, kallikrein and fibrinolytic systems are affected by storage of plasma at +6 degrees C. Blood was collected into citrate phosphate dextrose adenine (CPD) or acid citrate dextrose (ACD) and the plasma samples were stored at +6 degrees C for 35 days. Samples were taken at weekly intervals for assays of various parameters of the different systems. No significant changes were observed in the levels of the main thrombin inhibitor, antithrombin III. At the end of the storage period, however, fibrinopeptide A levels increased markedly, particularly in the ACD plasma, indicating thrombin activation. There was no change in the plasminogen level, but a decrease in the levels of antiplasmin and urokinase inhibitors and an increase in the level of the fibrinogen degradation fragment B beta 15-42 were observed, indicating activation of the fibrinolytic system. The level of antikallikrein activity decreased sharply in ACD plasma; CPD plasma was less affected. This decrease was parallel to the increase in spontaneous proteolytic activity and correlated with the increase in fibrinopeptide A. Prolonged storage of plasma of +6 degrees C thus resulted in the activation of coagulation, fibrinolytic and kallikrein systems and decrease in inhibitors. The activation was much more pronounced in ACD than in CPD plasma.

Topics: Anticoagulants; Aprotinin; Blood Coagulation; Blood Preservation; Citrates; Citric Acid; Cold Temperature; Complement C1 Inactivator Proteins; Fibrinolysis; Fibrinopeptide A; Glucose; Humans; Kallikreins