Coagulation factor content of solvent/detergent plasma compared with fresh frozen plasma

Solvent/detergent (S/D) plasma is being increasingly widely used in clinical practice, as it carries significantly lower risk of lipid-enveloped viral transmission than standard fresh frozen plasma (FFP). However, previous reports have suggested that S/D processing might influence the coagulation factor content of plasma. We have investigated this question by measuring procoagulant factors (fibrinogen, factor V and factor VIII), anticoagulant factors (protein C and protein S) and routine coagulation screening tests (prothrombin time and activated partial thromboplastin time) in 48 single-donor units of FFP, and in 16 units of S/D plasma (Octaplas). All routine coagulation screening tests, factor VII and protein C levels were within the normal reference range for both S/D plasma and FFP. However, we found significant reductions in factor V (31%), factor VIII (28%) and protein S (50%) in S/D plasma. The observed quantitative differences in coagulation factor levels may be further exacerbated by the lower volume of solvent detergent plasma units (200 ml) compared with units of standard fresh frozen plasma (250 ml). These findings are of potential clinical significance, particularly in those patients with liver disease, constitutional factor V deficiency and congenital or acquired protein S deficiency.