ArticleThe journal of trauma and acute care surgery2026
Whole blood becomes increasingly susceptible to tPA-mediated fibrinolysis with storage.
Article in The journal of trauma and acute care surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Prehospital Resuscitation with Type O Whole Blood for Trauma and Hemorrhage.The New England journal of medicine · 2026Trial
- Whole blood storage time impairs clot strength with minimal change in functional fibrinogen concentration.Transfusion · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors.
Funding
Abstract
backgroundWhole blood transfusion is increasingly used in trauma resuscitation, but its hemostatic effectiveness over time remains unclear. Separately, hyperfibrinolysis is a known pathologic result of major trauma that contributes to death by exsanguination. Emerging data suggest the functional integrity of whole blood components, particularly fibrinogen, may deteriorate during WB storage, but no studies on how whole blood storage impacts sensitivity to tPA have been performed to date. This study set out to investigate how whole blood storage affects susceptibility to tissue plasminogen activator (tPA)-mediated fibrinolysis and explore potential mechanisms contributing to any observed changes.
methodsWhole blood was obtained (n = 34) from a local urban blood bank and stored at 4C. Thromboelastography with 75 ng/mL tPA was performed at three storage intervals: Days 1-3, Days 7-11, and Day 21. Fibrinogen function was evaluated using alpha angle and platelet function via maximum amplitude metrics. Plasminogen activator inhibitor type 1 activity was quantified in plasma from stored whole blood via a commercially available activity assay, and hemolysis was measured using Harboe method. ANOVA and Spearman correlations were performed with significance set at p < 0.05.
resultsSensitivity to tPA-induced fibrinolysis increased significantly with storage duration, with LY30 values rising nearly threefold by expiration ( p < 0.0001). Alpha angle and MA declined over time, and MA had a strong inverse correlation with tPA sensitivity. Hemolysis rose with storage ( p < 0.0001) but was not significantly correlated with tPA sensitivity ( r = 0.231, p < 0.073). Plasminogen activator inhibitor type 1 levels paradoxically increased with time, suggesting it does not drive the observed increase in tPA sensitivity.
conclusionStored whole blood becomes increasingly vulnerable to tPA-mediated fibrinolysis, potentially due to a combination of declining fibrinogen and platelet function. These findings raise considerations for clinical use of older whole blood units and support the potential role of adjunctive therapies during trauma resuscitation.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.