fresh frozen plasma
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Introduction
A unit of fresh frozen plasma is obtained from centrifugation of 500 mL of whole blood. 200 mL of plasma is separated from 300 mL of packed red blood cells & stored frozen for up to 1 year.
Indications
- treatment of coagulation abnormalities secondary to multiple clotting factor deficiencies
- treatment of thrombotic thrombocytopenic purpura (TTP) in association with plasmapheresis
- for correction of specific clotting factor deficiencies when specific clotting factors are not available
- prothrombin deficiency
- factor V deficiency
- factor VII deficiency
- factor IX deficiency (hemophilia B, Christmas disease)
- factor XI deficiency
- correction of coagulation inhibitor deficiencies
- correction of warfarin therapy* when reveral by vitamin K is not feasible because of time constraints
- infants with protein-losing enteropathy
- massive transfusion of packed RBC to avoid dilutional coagulopathy[2]
- replacement solution for plasma exchange[2]
* prothrombin complex concentrate is preferred; the 2 may be given together[2]
Contraindications
- specific factor deficiencies for which the isolated factor is available as a single component
- factor VIII deficiency
- factor IX deficiency
- fibrinogen deficiency
- as a simple volume expander
- ineffective for treating mild coagulopathy (INR < 1.9)[2]
- no consistent evidence of significant benefit for prophylactic or therapeutic use[4]
Pharmacokinetics
- duration of effect is limited by short 1/2life of factor VII[1]
Complications
- transfusion-related acute lung injury
- transfusion-related infection
- transfusion-related circulatory overload
- allergic reactions, anaphylaxis[2]
- hemolysis
Management
- compatibility of donor plasma with recipient erythrocytes
- recipient blood type A is compatible with donor plasma type A & AB
- recipient blood type B is compatible with donor plasma type B & AB
- recipient blood type AB is compatible with donor plasma type AB
- recipient blood type O is compatible with any donor plasma type[2]
- transfusion:
- 10 mL/kg or 1 unit/20 kg of ideal body weight
- consider coadministration of vitamin K
More general terms
Additional terms
References
- ↑ Jump up to: 1.0 1.1 Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 613-614
- ↑ Jump up to: 2.0 2.1 2.2 2.3 2.4 2.5 2.6 Medical Knowledge Self Assessment Program (MKSAP) 11, 16, 17, 18. American College of Physicians, Philadelphia 1998, 2012, 2015, 2018.
- ↑ Roback JD, Caldwell S, Carson J et al Evidence-based practice guidelines for plasma transfusion. Transfusion. 2010 Jun;50(6):1227-39 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20345562
- ↑ Jump up to: 4.0 4.1 Yang L, Stanworth S, Hopewell S, Doree C, Murphy M. Is fresh-frozen plasma clinically effective? An update of a systematic review of randomized controlled trials. Transfusion. 2012 Aug;52(8):1673-86; PMID: https://www.ncbi.nlm.nih.gov/pubmed/22257164
- ↑ Fresh Frozen Plasma: Indications and Risks NIH Consensus Statement http://consensus.nih.gov/cons/045/045_intro.htm