Evidence map›Paper›PMID 41811116›Full record

ArticleTransfusion2026

Whole blood storage time impairs clot strength with minimal change in functional fibrinogen concentration.

Elizabeth R Maginot, Nicolle K Barmettler, Flobater I Gawargi, Collin M White, Natasha Goodman, Timothy R Billiar, Refael Munitz, Scott A Koepsell, Shelly M Williams, Aleh Bobr and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Transfusion, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Elizabeth R MaginotDivision of Acute Care Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Nicolle K BarmettlerDivision of Acute Care Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Flobater I GawargiDivision of Acute Care Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Collin M WhiteDivision of Acute Care Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Natasha GoodmanDivision of Acute Care Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Timothy R BilliarDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.ORCID https://orcid.org/0000-0002-2949-0811
Refael MunitzTrauma and Transfusion Medicine Research Center, Department of Surgery, University of Pittsburgh, Pennsylvania, USA.
Scott A KoepsellDepartment of Pathology, Microbiology and Immunology, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Shelly M WilliamsDepartment of Pathology, Microbiology and Immunology, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Aleh BobrDepartment of Pathology, Microbiology and Immunology, University of Nebraska Medical Center, Omaha, Nebraska, USA.ORCID https://orcid.org/0000-0003-1597-8071
Phillip C SpinellaDepartment of Surgery, Division of Trauma, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Susan M SheaTrauma and Transfusion Medicine Research Center, Department of Surgery, University of Pittsburgh, Pennsylvania, USA.ORCID https://orcid.org/0000-0003-3756-2747
Reynold HenryDivision of Acute Care Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Christopher D BarrettDivision of Acute Care Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska, USA.ORCID https://orcid.org/0000-0001-9720-8155

Funding

Using Patient-Reported Outcomes, Inflammatory Profiles, and Cardiovascular Phenogroups to Expand the Definition of Heart Failure with Preserved Ejection FractionP20GM152326 · NIGMS · UNIVERSITY OF NEBRASKA MEDICAL CENTER · PI Rebekah L. Gundry · 2024 to 2026
$10.3M
Mechanisms of Complement Activation in Traumatic InjuryK08HL171936 · NHLBI · UNIVERSITY OF NEBRASKA MEDICAL CENTER · PI Christopher David Barrett · 2024 to 2026
$500k
NHLBI NIH HHS K08 HL171936NHLBI NIH HHS K08-HL171936NIGMS NIH HHS P20 GM152326NIGMS NIH HHS P20-GM152326
6 · The paper itself

Abstract

backgroundWhole blood (WB) is a preferred resuscitation strategy, yet how storage affects hemostasis remains unclear. Prior studies have shown decreased fibrinogen function during storage; however, these were limited by incomplete removal of platelet contributions. Additionally, leukoreduced (LR) versus non-leukoreduced (NLR) status in preserving fibrinogen remains unknown. STUDY

methodsWB units (n = 15, 7 NLR, 8 nLR) were evaluated at serial time points through day 35. ROTEM EXTEM was performed. Platelet-poor plasma (PPP) from WB at day 0, day 21, and day 35 underwent western blot for fibrinogen. Functional fibrinogen was measured using the Clauss assay after freeze-thaw cycles of WB PPP to minimize platelet contribution.

resultsAs WB aged, there was a progressive decrease in alpha angle and maximum clot firmness. Platelet count dropped sharply by day 7. Western blot demonstrated no evidence of fibrinogen degradation in either LR or NLR WB. Clauss fibrinogen concentrations were unchanged from day 0 to day 35, with a modest non-significant decline by day 35 driven primarily by NLR units. DISCUSSION: Fibrinogen did not undergo detectable proteolysis during storage of WB and had preserved function through day 35 after freeze-thaw cycles to minimize platelet contributions. NLR appeared to impact fibrinogen function with medians below 200 for day 21 and 35 but was not statistically significant. This suggests that previously reported reductions in fibrinogen function may be based on leukoreduction status, but that early changes in fibrinolysis sensitivity are more likely due to residual platelet contributions to the assays rather than loss of fibrinogen function itself.

Indexed as

Blood CoagulationBlood PreservationFibrinogenBlood PlateletsHumansLeukocyte Reduction ProceduresPlatelet CountThrombelastographyTime FactorsFibrinogenfibrinogen stabilityleukoreductionROTEMwhole blood storage

Identifiers

PMID41811116
PMCPMC13367526

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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.