Fresh Frozen Plasma

There are many different components to blood. Blood is primarily made up of red blood cells, white blood cells, platelets and plasma. Plasma is the part of blood that contains its clotting factors and antibodies. When preserved, the components are called fresh frozen plasma or FFP.

If you need to receive a transfusion, the blood you receive is probably made of several different units of donated blood. What you get depends on what you need it for and the specific treatment desired. Often, different components are pooled together from several donors. You may only get platelets or plasma. In some cases, you will only receive clotting factors. Not only will it reduce your risk of side effects, it also allows a single unit of donated blood the ability to treat several individuals.

What Is Fresh Frozen Plasma?

When someone refers to fresh frozen plasma, they are speaking about the liquid portion of donated human blood that has been frozen for blood transfusions at a later date. In the U.S., the capitalized phrase Frozen Frozen Plasma refers to the centrifuged, separated and frozen fluid portion of one unit of blood. In order to qualify, this process must be completed within eight hours of collection and the unit of human blood must be frozen solid at 0 °F (−18 °C) or colder.

While the abbreviated phrase FFP is commonly used to refer to all types of transfused plasma product, there is another type of transfused plasma called PF24. It is similar to FFP except its plasma contains heat-sensitive proteins.

What Is Fresh Frozen Plasma Used For?

FFP can be used for the treatment of many different types of conditions. Since a unit of it contains all coagulate factors, it can be used for individuals with a coagulopathy at risk of bleeding or who are actively bleeding. Fresh frozen plasma administration can be used when a specific factor concentrate is not readily available.

During a massive transfusion, fresh frozen plasma administration is appropriate to replace plasma coagulation factors. For the same reason, it can be used for liver disease, cardiac bypass and acute disseminated intravascular coagulation with bleeding.

When Prothrombinex Compex Concentrates are not available, FFP is recommended for patients in the case of warfarin overdose. This is especially suggested in life-threatening situations that require preoperative warfarin reversal.

Safety Information on Fresh Frozen Plasma

The general guide for fresh frozen plasma administration is 10-15 mL/kg per dose. However, the specific volume transfused is affected by patient size and the medication situation.

There are several circumstances when FFP should not be used. If you can safely replace blood volumes, you should avoid its administration. During plasma exchange procedures, fresh frozen plasma should be avoided except in the case of treatment for thrombotic thrombocytopenic purpura. If you can fix coagulopathy using specific therapies like cryoprecipitate or vitamin K and for the treatment of immunodeficiency states, you should not use FFP.

What Are the Risks of Fresh Frozen Plasma?

As with any medical procedure, fresh frozen plasma administration carries its own risk. You may contract disease, experience excessive intravascular volume, suffer an anaphylactoid reaction or alloimmunization. There is the chance of posttransfusion hepatitis, dependent of other factors as well. The probability of nonicteric and icteric hepatitis after multiple transfusions can range up to 10 percent. There are rare instances in which patients have acquired AIDS by FFP transfusions. However, the potential for viral infectivity is close to that of whole blood.

FFP also carries the risk of an allergic reaction. The reaction can vary from simple hives to fatal noncardiac pulmonary edema. Fresh frozen plasma is like any intravenously administered fluid where excessive amounts may cause cardiac failure and hypervolemia.

How Effective Is Fresh Frozen Plasma?

Use of FFP in clinical cases is becoming increasingly more common. However, there is insufficient evidence to support its effectiveness. Even though it is a sound solution for intravascular volume replacement, especially when acute blood loss is present, there are alternative therapies that work just as well.

Additionally, there is not any evidence that FFP is better for you when administered as part of the treatment for a patient with massive hemorrhage. There are other blood derivatives and components that have greater efficacy, even though FFP has coagulation factors and plasma proteins.

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