Transfusion of Stored Fresh Whole Blood in a Civilian Trauma Center: A Prospective Evaluation of Feasibility and Outcomes
Principal Investigator: Henry Gill Cryer, MD
Site: University of California-Los Angeles (UCLA)
Whole blood (WB) transfusion is a promising alternative to component therapy. Use of banked WB requires filtration of white blood cells (leukoreduction) and an established shelf life during which WB retains coagulant capacities. The goal of this study was to define the time course of coagulation stability in leukoreduced compared to unfiltered WB under standard refrigeration conditions. Twelve WB units were donated by healthy volunteers after routine screening. Five units underwent standard leukocyte filtration and five did not. Two units were aliquoted into filtered and unfiltered samples, with platelets added to each sample on Day 14. Units were stored at 4⁰C and sampled on days 0, 1, 2, 3, 4, 5, 6, 7, 10, 14, 21, 28 and 35 for immediate thromboelastogram (TEG) analysis, and centrifuged and stored at 80⁰C for later Calibrated Automated Thrombogram (CAT) and coagulation factor assays. This study received additional funding from the Joint Warfighter Medical Research Program (JWMRP) in 2015 and is ongoing.
Eastoak Siletz A, Burruss S, Gruber T, Ziman A, Marder V, Cryer H. Leukocyte filtration lesion impairs functional coagulation in banked whole blood. J Trauma Acute Care Surg. 2016 Publish Ahead of Print.
Connelly CR, Van PY, Hart K, Fair K, Louis S, Rick B, Erickson A, Simeon E, Bulger EM, Arbabi S, Holcomb JB, Moore LJ, Schreiber MA. “Thrombelastography-Based Dosing of Enoxaparin for Thromboprophylaxis in Trauma and Surgical Patients: A Randomized Clinical Trial.” JAMA Surg. 2016:151(10). DOI: 10.1001/jamasurg.2016.2069