Are quality differences responsible for different adverse reactions reported for SD-plasma from USA and Europe?

Transfus Med. 2006 Aug;16(4):266-75. doi: 10.1111/j.1365-3148.2006.00672.x.


Thromboembolic adverse reactions reported after transfusion of SD-plasma in the United States (US) prompted us to perform a comparative study with SD-plasma from the US and the European (EU) market. In SD-plasma from US, residual tri-N-butyl phosphate was found, and citrate concentrations were lower than in EU-plasma. Except for substantial losses of FV, FVIII and antiplasmin found for all SD-plasmas, clotting factor activities were mainly retained. However, for SD-plasma from US, markedly elevated concentrations of lipoprotein (a) [Lp(a)], fibrin monomer and a particularly high degree of complement activation (C3a des-Arg) were observed. Furthermore, pronounced differences were found for protein S. Although SD-plasma pools from US contained nearly normal concentrations of free and bound protein S antigen, protein S activities were almost completely absent. In contrast to this, SD-plasma from EU showed a moderate loss of both protein S activity and free antigen. Antitrypsin inhibitor activities were much more diminished in SD-plasma from US than from EU. In view of a possible thrombogenicity of SD-plasma from US, the loss of protein S and elevated Lp(a) concentrations could be of significance. The very high levels of C3a des-Arg in US plasma could possibly have an additional effect, through priming platelet activation after transfusion.

Publication types

  • Comparative Study

MeSH terms

  • Blood Coagulation Factors / analysis
  • Complement C3a / analysis
  • Europe
  • Fibrin / analysis
  • Humans
  • Lipoprotein(a) / analysis
  • Plasma / chemistry
  • Plasma Exchange / adverse effects*
  • Plasma Exchange / standards*
  • Protein S / analysis
  • Thromboembolism / etiology
  • United States


  • Blood Coagulation Factors
  • Lipoprotein(a)
  • Protein S
  • Complement C3a
  • Fibrin