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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">mes</journal-id><journal-title-group><journal-title xml:lang="ru">Экстремальная биомедицина</journal-title><trans-title-group xml:lang="en"><trans-title>Extreme Medicine</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">3033-8964</issn><issn pub-type="epub">3033-8972</issn><publisher><publisher-name>Centre for Strategic Planning of the Federal Medical and Biological Agency</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.47183/mes.2025-248</article-id><article-id custom-type="elpub" pub-id-type="custom">mes-248</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>Статьи</subject></subj-group></article-categories><title-group><article-title>Лиофилизированная плазма для оказания экстренной трансфузиологической помощи в экстремальных условиях</article-title><trans-title-group xml:lang="en"><trans-title>Freeze-dried plasma for emergency transfusion care in extreme conditions</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0949-3783</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Зиганшина</surname><given-names>С. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Ziganshina</surname><given-names>S. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Зиганшина Светлана Евгеньевна</p><p>Киров</p></bio><bio xml:lang="en"><p>Svetlana E. Ziganshina</p><p>Kirov</p></bio><email xlink:type="simple">ziganshina@niigpk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8158-8445</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кормщикова</surname><given-names>Е. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Kormshchikova</surname><given-names>E. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кормщикова Елена Сергеевна, канд. биол. наук</p><p>Киров</p></bio><bio xml:lang="en"><p>Elena S. Kormshchikova, Cand. Sci. (Biol.)</p><p>Kirov</p></bio><email xlink:type="simple">kormschikova@niigpk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9754-5522</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Калинина</surname><given-names>Е. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Kalinina</surname><given-names>E. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Калинина Елена Николаевна</p><p>Киров</p></bio><bio xml:lang="en"><p>Elena N. Kalinina</p><p>Kirov</p></bio><email xlink:type="simple">kalininaen@niigpk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0004-0228-5115</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Росина</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Rosina</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Росина Елена Владимировна</p><p>Киров</p></bio><bio xml:lang="en"><p>Elena V. Rosina</p><p>Kirov</p></bio><email xlink:type="simple">rosina@niigpk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8508-6365</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Коновалова</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Konovalova</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Коновалова Екатерина Анатольевна</p><p>Киров</p></bio><bio xml:lang="en"><p>Ekaterina A. Konovalova</p><p>Kirov</p></bio><email xlink:type="simple">konovalovaea@niigpk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8457-2967</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Игнатьев</surname><given-names>С. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Ignatyev</surname><given-names>S. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Игнатьев Сергей Викторович, канд. мед. наук</p><p>Киров</p></bio><bio xml:lang="en"><p>Sergey V. Ignatyev, Cand. Sci. (Med.)</p><p>Kirov</p></bio><email xlink:type="simple">ignatyev@niigpk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5509-5308</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лянгузов</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Lyanguzov</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Лянгузов Алексей Владимирович, канд. мед. наук</p><p>Киров</p></bio><bio xml:lang="en"><p>Aleksey V. Lyanguzov, Cand. Sci. (Med.)</p><p>Kirov</p></bio><email xlink:type="simple">lyanguzov@niigpk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0006-4923-9436</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Эйхлер</surname><given-names>О. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Eihler</surname><given-names>O. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Эйхлер Ольга Валерьевна</p><p>Москва</p></bio><bio xml:lang="en"><p>Olga V. Eihler</p><p>Moscow</p></bio><email xlink:type="simple">fmba@fmba.gov.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4386-5835</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Воробьев</surname><given-names>К. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Vorobiev</surname><given-names>K. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Воробьев Константин Анатольевич, д-р биол. наук</p><p>Киров</p></bio><bio xml:lang="en"><p>Konstantin A. Vorobiev, Dr. Sci. (Biol.)</p><p>Kirov</p></bio><email xlink:type="simple">vorobiev@niigpk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7205-912X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Парамонов</surname><given-names>И. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Paramonov</surname><given-names>I. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Парамонов Игорь Владимирович, д-р мед. наук</p><p>Киров</p></bio><bio xml:lang="en"><p>Igor V. Paramonov, Dr. Sci. (Med.)</p><p>Kirov</p></bio><email xlink:type="simple">paramonov@niigpk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Кировский научно-исследовательский институт гематологии и переливания крови Федерального медико-биологического агентства</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Kirov Research Institute of Hematology and Blood Transfusion</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Федеральное медико-биологическое агентство</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal Medical and Biological Agency</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>08</day><month>09</month><year>2025</year></pub-date><volume>27</volume><issue>3</issue><fpage>271</fpage><lpage>282</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Зиганшина С.Е., Кормщикова Е.С., Калинина Е.Н., Росина Е.В., Коновалова Е.А., Игнатьев С.В., Лянгузов А.В., Эйхлер О.В., Воробьев К.А., Парамонов И.В., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Зиганшина С.Е., Кормщикова Е.С., Калинина Е.Н., Росина Е.В., Коновалова Е.А., Игнатьев С.В., Лянгузов А.В., Эйхлер О.В., Воробьев К.А., Парамонов И.В.</copyright-holder><copyright-holder xml:lang="en">Ziganshina S.E., Kormshchikova E.S., Kalinina E.N., Rosina E.V., Konovalova E.A., Ignatyev S.V., Lyanguzov A.V., Eihler O.V., Vorobiev K.A., Paramonov I.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.extrememedicine.ru/jour/article/view/248">https://www.extrememedicine.ru/jour/article/view/248</self-uri><abstract><sec><title>Введение</title><p>Введение. В условиях ограниченных возможностей применения свежезамороженной плазмы в экстремальных условиях важны логистические преимущества, которые дает использование лиофилизированной плазмы. Эффективность ее применения зависит от сохранности коагуляционного потенциала в процессе производства.</p></sec><sec><title>Цель</title><p>Цель. Анализ перспективных направлений совершенствования технологий получения лиофилизированной плазмы с использованием международного и отечественного опыта производства, оценки контроля качества и применения гемокомпонента.</p></sec><sec><title>Обсуждение</title><p>Обсуждение. Применяющиеся и доказавшие свою эффективность и безопасность коммерческие препараты FLyP, LyoPlas N-w и Bioplasma FDP, OctaplasLG Lyo, а также лиофилизированная плазма Республики Беларусь и КНР выпускаются в стеклянных флаконах. Перспективным направлением считается получение лиофилизированной плазмы в полимерных контейнерах с применением мембранной технологии, что обеспечивает преимущества использования гемокомпонента в экстремальных условиях. Известны разработки компаний Terumo BCT Biotechnologies и Teleflex Inc., полученные ими продукты лиофилизированной плазмы находятся на стадии клинических исследований и ограниченно применяются в военных операциях. В Российской Федерации зарегистрирован полимерный контейнер «Лиокон». В процессе лиофилизации наблюдается увеличение рН до щелочных значений порядка 8, что связано с удалением углекислого газа. При оценке коагуляционного потенциала наиболее значимо снижение активности фактора VIII до 50%, фактора V — до 37%, протеина S — до 34%, фактора Виллебранда — до 25%. Отмечена пролонгация протромбинового времени (ПВ) и активированного частичного тромбопластинового времени (АЧТВ). В Российской Федерации лиофилизированная плазма относится к гемокомпонентам, поэтому внедрение зарубежного опыта производства (внесение крио- и лиопротекторов, корректировка рН и др.) ограничено законодательно, что подчеркивает важность разработки отечественных технологий.</p></sec><sec><title>Выводы</title><p>Выводы. Производство лиофилизированной плазмы в полимерных контейнерах является одним из путей бесперебойного трансфузионного обеспечения при оказании медицинской помощи, что будет способствовать повышению выживаемости раненых с острой кровопотерей в чрезвычайных ситуациях. В связи с этим актуально создание отечественных технологий лиофилизации плазмы и разработка подходов к повышению ее эффективности.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Introduction</title><p>Introduction. In the context of limited availability of fresh frozen plasma, the use of freeze-dried plasma offers significant logistical advantages in extreme conditions. The effectiveness of freeze-dried plasma depends on the preservation of coagulation potential in the manufacturing process.</p></sec><sec><title>Objective</title><p>Objective. Review of research achievements both in Russia and aboard in the field of freeze-dried plasma technologies, including manufacturing, quality control, and blood component application.</p></sec><sec><title>Discussion</title><p>Discussion. Commercial products such as FLyP, LyoPlas N-w, Bioplasma FDP, OctaplasLG Lyo, as well as freeze-dried plasma (Belarus or China), which have proven their effectiveness and safety, are available in glass vials. The production of freeze-dried plasma in polymer containers using membrane technology is a promising direction offering the advantage of using blood components in extreme conditions. The freeze-dried plasma products developed by Terumo BCT Biotechnologies and Teleflex Inc. are currently undergoing clinical trials and are used in military operations to a limited extent. In the Russian Federation, the Lyokon polymer container has been registered. During the lyophilization process, the pH increases to alkaline pH values of 8, which is associated with the removal of carbon dioxide. When assessing the coagulation potential, the most significant decrease is observed in the activity of factor VIII — up to 50%, factor V — up to 37%, protein S — up to 34%, and von Willebrand Factor — up to 25%. The prolongation of prothrombin time (PT) and activated partial thromboplastin time (aPTT) is noted. In the Russian Federation, freeze-dried plasma belongs to the group of blood components; therefore, the introduction of foreign production experience (the introduction of cryo- and lyoprotectors, pH adjustment, etc.) is restrained by legislation. This emphasizes the importance of developing domestic technologies.</p></sec><sec><title>Conclusions</title><p>Conclusions. The production of freeze-dried plasma in polymer containers contributes to uninterrupted transfusion support in the provision of medical care, thus increasing the survival rate of the injured with acute blood loss in emergency situations. In this regard, creation of domestic plasma lyophilization technologies and enhancement of their effectiveness are relevant tasks.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>лиофилизированная плазма</kwd><kwd>технология получения</kwd><kwd>лиофилизация</kwd><kwd>коагуляционный потенциал</kwd><kwd>трансфузионная терапия</kwd></kwd-group><kwd-group xml:lang="en"><kwd>freeze-dried plasma</kwd><kwd>production technology</kwd><kwd>lyophilization</kwd><kwd>coagulation potential</kwd><kwd>transfusion therapy</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Работа выполнена в рамках государственного задания ФМБА России № 124032600074-3 на проведение прикладных научных исследований.</funding-statement><funding-statement xml:lang="en">The work was carried out within the framework of the state assignment of the FMBA of Russia (No. 124032600074-3).</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Григорьев ЕВ, Лебединский КМ, Щеголев АВ, Бобовник СВ, Буланов АЮ, Заболотских ИБ и др. 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