Refrigerated canine plasma, haemostatic stability and clinical utility

Weiqin Chee

Canine fresh frozen (FFP) transfusions are routinely utilised for the correction of coagulopathies. Refrigerated never frozen plasma (NFzP, also known as liquid plasma. [LP]) and thawed plasma (TP) are used in human medicine to overcome delays posed by thawing. However, the retention of coagulation factor (CF) activity beyond 14 days of storage, and the clinical utility of these products, remains unknown in dogs. A prospective laboratory study was performed to investigate the stability of CFs (FV, FVII, FVIII, FIX, FX, von Willebrand Factor [vWF]) and fibrinogen in NFzP and TP over 42 days. To be considered suitable for transfusion, the lower bounds of the 95% confidence interval (CI) for the individual CFs had to be above 50% activity. The 95% CI for FVIII and vWF activity remained above 50% up to and including day 32 for NFzP and day 28 for TP. Confidence intervals for FV, FVII, FIX and FX remained above 50% activity at all time points. To address knowledge gaps regarding the clinical use of TP, we reported a case series describing the indications, outcomes and adverse events associated with TP use in 172 dogs between December 2015 and June 2021. Anticoagulant rodenticide intoxication (37/172, 21.5%) was the most common indication for TP, followed by spontaneous hemoperitoneum (22, 12.8%), and traumatic haemorrhage (22, 12.8%). The majority of dogs received a single unit of TP (116, 67.4%), were hospitalised for more than 12 hours (154, 89.5%), and survived to discharge (103, 59.9%). Severe prolongations of PT and aPTT were reduced following TP transfusions. Allergic reactions were the most common transfusion reaction and the overall transfusion reaction rate was 16.2% (28/172). In conclusion, the expiry date of NFzP and TP can be extended to 32 and 28 days respectively, while further prospective studies should be performed to investigate for potential time savings with the use of TP.

Refrigerated canine plasma, haemostatic stability and clinical utility

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