An assessment of green plasma: The in vitro hemostatic superiority of a currently discarded blood product

Introduction Recent studies have linked trauma patient outcomes to the plasma donor's sex, with premenopausal females associated with improved survival and lower organ failure. Currently, green‐colored plasma (due to oral contraceptive use) is removed from the donor pool. We set out to evaluate the hemostatic potential of green plasma. Study Design & Methods We obtained 90 units of plasma from our regional blood center: 30 units of visible green plasma and 60 units of standard‐color plasma divided between male and female donors. We collected clinical data such as age, sex, ethnicity, and number of pregnancies. We then assessed the hemostatic potential through thrombelastography ( TEG ), calibrated automated thrombography ( CAT ), and clotting factor levels. Results Green plasma unit donors were younger than standard‐color female and male donor units (median age 27 vs. 58 vs. 54) and had fewer pregnancies than their non‐green female counterparts (median 0 vs. 2); (both p < 0.001). All TEG values, as well as CAT lag time, thrombin potential, and peak thrombin were more hypercoagulable in the green plasma group compared to standard‐color female and male donor units; all p < 0.05. In addition, the majority of factor levels (including II, VII, IX, X, and fibrinogen) were higher in green donor plasma; all p < 0.05. Discussion Based on our data, green plasma has superior hemostatic potential without any other aberrant characteristics, possibly justifying the use of green plasma in transfusion medicine. Reintroducing this product will help to expand on the plasma donor pool.