A modified form of donor plasma could offer a safer alternative for patients undergoing therapeutic plasma exchange (TPE), a procedure commonly used to treat serious autoimmune and blood disorders, including fetal and neonatal alloimmune thrombocytopenia (FNAIT). Results of the study were recently published inTransfusion.
TPE involves removing a patient’s plasma and replacing it with donor plasma to eliminate harmful antibodies or disease-causing proteins. In cases of severe FNAIT, TPE is used to rapidly remove maternal anti-platelet IgG antibodies that are harmful to the fetus. While the procedure can be life-saving, it carries a risk of infection and potential clotting complications.
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In the new study, investigators evaluated pathogen-reduced, cryoprecipitate-reduced plasma, a product that undergoes treatment with amotosalen and ultraviolet A (UVA) light to inactivate viruses, bacteria and other pathogens before transfusion. The pathogen-reduction system used in the product has been cleared by the U.S. Food and Drug Administration for use in certain transfusion settings.
The researchers performed a series of laboratory tests to see how well this modified plasma preserved important blood-clotting proteins. They found that some clotting components, including fibrinogen, factor VIII and von Willebrand factor, were lower than in standard plasma.
However, many other key clotting factors, including factors II, V, VII, IX, X, XI and XIII, as well as natural anticoagulants protein C and protein S, remained at levels considered adequate for normal blood clotting.
The researchers also examined how the plasma behaved under conditions that mimic blood flow in the body. The results showed that the plasma supported platelet adhesion under normal flow conditions. At very high shear rates, which simulate flow in small blood vessels, the plasma demonstrated minimal clumping, suggesting the product could potentially reduce the risk of thrombosis.
While the findings are based on laboratory data rather than patient outcomes, the authors conclude that the modified plasma retains essential hemostatic and immunologic properties while potentially reducing infectious and clotting risks.
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