Evaluation of the efficacy and safety of lyophilized plasma

E. V. Dashkevich, O. N. Bondaruk, N. A. Fiadura, V. I. Asaevich, I. V. Kurlovich, R. N. Demidova, S. N. Ryabtseva
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Abstract

Objective. To assess the hemostatic potential, preclinical safety and in vitro efficacy of lyophilized plasma in patients and blood donors.Materials and methods. The study of acute toxicity was carried out on outbred mice of both sexes (n=120), pyrogenicity – on rabbits of both sexes (n=30), abnormal toxicity – on mice (n=25) and guinea pigs (n=6). Histopathological studies were carried out on preparations of five fragments of the middle part of the mouse tail after intravenous administration of the maximum dose (4500 mg/kg) lyophilized plasma (LP), physiological solution, fresh frozen plasma (FFP) and pathogen-reduced FFP (PRFFP) using the Intercept system. The proand anticoagulant activity was investigated by clotting and chromogenic method to evaluate the hemostatic potential of PL. The effect on hemostasis was studied in vitro by thromboelastometry when FFP and LP were added to blood samples of patients (n = 23) and donors (n = 20). Results. Acute toxicity study showed the absence of death and clinical signs of intoxication in all series. On the 14th day, body weight gain was observed in animals of all series. Regardless of the used LP dosage, no development of effusion and adhesions in the thoracic and abdominal cavities, as well as macroscopically detectable pathologic changes of the main organs were observed in animals. The analysis of the relative weight of internal organs of animals did not reveal statistically significant differences in experimental and control series relative to the values of similar indicators in intact animals. The studied hemostatic potential showed that LP was not inferior to PRFFP in the content of coagulation factors of the blood system. Evaluation of the effect of LP application in vitro in female patients showed statistically significant correction of CT (clotting time) index, which indicates the effectiveness of its application for replenishment of blood coagulation factors (BCF).Conclusion. Preclinical animal studies of LP have proven its safety and efficacy compared to FFP.
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冻干血浆的疗效和安全性评估
目的评估冻干血浆在患者和献血者体内的止血潜能、临床前安全性和体外药效。急性毒性研究对象为雌雄近交系小鼠(n=120),热原性研究对象为雌雄家兔(n=30),异常毒性研究对象为小鼠(n=25)和豚鼠(n=6)。在使用 Intercept 系统静脉注射最大剂量(4500 毫克/千克)的冻干血浆(LP)、生理溶液、新鲜冷冻血浆(FFP)和病原体还原 FFP(PRFFP)后,对小鼠尾部中间部分的五个片段进行了组织病理学研究。通过凝血法和显色法研究了 PL 的促凝和抗凝活性,以评估 PL 的止血潜力。将 FFP 和 LP 加入患者(23 人)和献血者(20 人)的血样中,通过血栓弹力测定法在体外研究其对止血的影响。结果显示急性毒性研究显示,所有系列的患者均无死亡和中毒的临床症状。第 14 天,所有系列的动物体重均有增加。无论使用何种 LP 剂量,动物的胸腔和腹腔均未出现渗出和粘连,主要器官也未出现宏观病理变化。对动物内脏器官相对重量的分析表明,与完整动物的类似指标值相比,实验系列和对照系列在统计学上没有显著差异。止血潜能研究表明,在血液系统凝血因子含量方面,LP 并不比 PRFFP 差。对女性患者体外使用 LP 的效果评估显示,CT(凝血时间)指数在统计学上有显著的修正作用,这表明使用 LP 可以有效补充凝血因子(BCF)。LP的临床前动物实验证明,与FFP相比,LP具有安全性和有效性。
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