{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T12:40:15Z","timestamp":1782218415802,"version":"3.54.5"},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T00:00:00Z","timestamp":1772841600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T00:00:00Z","timestamp":1772841600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In Japan, thawed plasma (TP) is not used because of the short expiration time of fresh frozen plasma (FFP) post\u2010thawing. We developed and implemented a new massive transfusion protocol (MTP) using TP and expired TP and evaluated its impact on plasma waste, transfusion response times, and patient outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design and Methods<\/jats:title>\n                    <jats:p>Phase 1: From November 2023 to March 2024, we investigated the clinical use of TP and the expiration rate of TP derived from 480\u2009mL of FFP (blood type: AB). The cryoprecipitate was prepared from expired TP (TP\u2010CRYO), and its coagulation factors were measured. Phase 2: From April 2024 to March 2025, TP\u2010CRYO was incorporated into a regular stock of type\u2010AB cryoprecipitate and administered to patients with massive bleeding. Clinical data, fibrinogen levels, and adverse events were investigated in patients who received TP and in those who received cryoprecipitate, including TP\u2010CRYO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During phase 1, TP was administered to 11 patients and 22 bags of TP expired. Compared with the conventionally prepared cryoprecipitate, TP\u2010CRYO had slightly higher clotting activity and fibrinogen levels. During phase 2, TP was administered to 55 patients, using 42 bags of expired TP. One bag of TP\u2010CRYO was discarded owing to early patient transfer, one due to fibrin formation, and three remained in stock. The other 37 were administered. The plasma waste rate decreased from 66.7% to 2.1%. No direct adverse events were associated with TP or TP\u2010CRYO use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>We established a sustainable MTP using TP and in\u2010house cryoprecipitate from TP\u2010CRYO.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.70158","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T21:07:15Z","timestamp":1773004035000},"page":"933-940","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Establishing a sustainable protocol for massive transfusion using thawed plasma and cryoprecipitate reconstituted from expired thawed plasma"],"prefix":"10.1111","volume":"66","author":[{"given":"Shigeko","family":"Nishimura","sequence":"first","affiliation":[{"name":"Department of Transfusion Medicine Tokyo Metropolitan Bokutoh Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiro","family":"Sugiyama","sequence":"additional","affiliation":[{"name":"Tertiary Emergency Medical Center Tokyo Metropolitan Bokutoh Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mai","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Clinical Laboratory Tokyo Metropolitan Bokutoh Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Fujita","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine Tokyo Metropolitan Bokutoh Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,7]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aet376"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2020.07.041"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002485"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.16869"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.18100"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1159\/000519700"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002472"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002765"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002920"},{"issue":"1","key":"e_1_2_11_11_1","first-page":"6","article-title":"Effects of in\u2010house cryoprecipitate on transfusion usage and mortality in patients with multiple trauma with severe traumatic brain injury: a retrospective cohort study","volume":"18","author":"Sugiyama K","year":"2020","journal-title":"Blood Transfus"},{"issue":"3","key":"e_1_2_11_12_1","first-page":"81","article-title":"Prothrombin complex concentrate for trauma induced coagulopathy: a systematic review and meta\u2010analysis","volume":"11","author":"Kao TW","year":"2021","journal-title":"J Acute Med"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.2147\/IJCTM.S99042"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.3925\/jjtc.64.516"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.3925\/jjtc.61.550"},{"issue":"2","key":"e_1_2_11_16_1","first-page":"310","article-title":"Fibcare shows correction with fibrinogen levels by the Clauss method during cardiopulmonary bypass","volume":"85","author":"Yamada A","year":"2023","journal-title":"Nagoya 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