Name: Plasma

Fresh Frozen Plasma (FFP)

Plasma Frozen Within 24 hours After Phlebotomy (FP24)

FFP Thawed

Thawed Plasma

Plasma, Cryoprecipitate Reduced

Description/Contents: All plasma products are prepared by separation from whole blood by centrifugation, or by hemapheresis using centrifugation or filtration. The volume of plasma varies and appears on the label. Fresh Frozen Plasma contains all soluble clotting factors and contains the plasma from one unit of whole blood, approximately 250 ml, separated and frozen within 8 hours of collection. FFP Thawed should be transfused within 24 hours. Plasma Frozen Within 24 hours After Phlebotomy has somewhat reduced levels of Factor VIII (65-80%). Thawed Plasma is a unit of FFP or FP24 thawed at 30-37 ^oC and maintained at 1-6 ^oC for up to 5 days. Levels of Factors V and VIII in Thawed Plasma are reduced and Thawed Plasma should not be used to treat patients with deficiencies of these factors. Plasma, Cryoprecipitate Reduced is prepared by thawing FFP at 4 ^oC and removing the Cryoprecipitate, which yields plasma that is depleted in Factor VIII, von Willebrand factor (vWF), fibrinogen, Factor XIII, and fibronectin. Other proteins such as albumin, Factors II, V, VII, IX, X, and XI are unaffected.

• Bleeding, preoperative, or massively transfused patients with a deficiency of multiple coagulation factors.

• Patients with bleeding and/or urgent invasive procedures on warfarin therapy. Vitamin K will reverse the warfarin defect in about 12 hours.

• Thrombotic thrombocytopenic purpura and related syndromes
• Congenital or acquired coagulation factor deficiency when no concentrate is available.

• Specific plasma protein deficiencies.

* Not all Plasma products are suitable for all the above indications. The choice of Plasma product should be based on the underlying deficiency and the contents of the available Plasma products (see Description/Contents). Consult the Blood Bank/Transfusion Medicine physician or Hematologist.

Plasma product transfusion for coagulopathies is not indicated unless the PT or aPTT is >1.5 times the midpoint of the normal values.

Dosage and Administration: Plasma product transfusions should be ABO compatible. Crossmatching and Rh compatibility are not required for plasma product transfusions. The usual starting dose is 10-15 mL/kg (i.e. 3-4 units for a 70-kg patient). An assessment of the effect of the product on the bleeding problem should be made before continuing therapy.

Alternative Therapy: For volume expansion, saline, other electrolyte solutions, albumin, or synthetic colloids are safer, cheaper and more effective. When appropriate, a specific coagulation factor concentrate should be used for treatment. Treatment with vitamin K can avoid the need for plasma transfusion in patients with vitamin K deficiency or on warfarin.

Fresh Frozen Plasma: Indication and Risks. NIH Consensus Statement, National Institutes of Health. Bethesda, Maryland, 1984.

Guidelines for Blood Utilization Review, American Association of Blood Banks. Bethesda, Maryland, 2001.

American Society of Anesthesiologists Task Force on Blood Component Therapy. Practice guidelines for blood component therapy. Anesthesiology 1996;84:732-47.

Practice Parameter for the use of FFP, Cryoprecipitate, and Platelets: Task Force of the American College of American Pathologists. JAMA 1994; 271: 777-81.

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Transfusion Guidelines

Plasma Guidelines	Antithrombin III Guidelines
Platelet Guidelines	Activated Protein Guidelines
Red Cell Guidelines	Factor IX Guidelines
Cryoprecipitate Guidelines	Factor VIII Guidelines
AICC/Porcine Factor VIII Guidelines	IVIG Guidelines Coagulation Factor VII Guidelines

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