Tuesday March 7, 2006
Some facts about FFP
Several plasma alternatives can be used for coagulation factor replacement. The most commonly used plasma component is Fresh Frozen Plasma (FFP). One unit of FFP or thawed plasma is the plasma taken from a unit of whole blood. It is frozen within eight hours of collection. FFP contains all coagulation factors in normal concentrations. Plasma may be stored for as long as I year at -18° C or colder. Thawed plasma may be transfused up to 5 days after thawing and contains slightly decreased levels of Factor V and decreased Factor VIII levels. Plasma is free of red blood cells, leukocytes and platelets. One unit is approximately 200-250mL and must be ABO compatible. Rh factor need not be considered. Since there are no viable leukocytes, plasma does not carry a risk of CMV transmission or Graft Vs. Host Disease (GVHD).
The dose of FFP depends on the clinical situation and the underlying disease process. Only 15% - 35% of normal levels of factors are required to maintain normal hemostasis. When FFP is given for coagulation factor replacement, the dose is 10-20 ml/Kg (4-6 units in an adult). This dose would be expected to increase the level of coagulation factors by 20% immediately after infusion. In a 70 kg Patient: 1 Unit Plasma increases most factors ~2.5%. 4 Units Plasma increase most factors ~10%.
FFP may be rapidly transfused over 20-30 minutes. The rate is mainly limited by the patient’s ability to tolerate the volume. Allergic reactions occur in approximately 1% of patients receiving FFP. The reactions are usually mild consisting of an urticarial rash (hives) and pruritus. FFP has not been associated with transmission of CMV or HTLV-I, II since these viruses are exclusively white cell associated and plasma is virtually acellular.
Related previous Pearl : How much FFP?
Also for your file:
1. Guidelines for the use of Fresh Frozen Plasma, cryoprecipitate and cryosupernatant from British Committee for Standards in Haematology, Blood Transfusion Task Force, British Society of Haematology - British Journal of Haematology 2004; 126, 11-28
2. Australian National Guidelines on FFP and Cryoprecipitate