Dr. Aisha Pervaiz, Dr. Lubna Naseem
Department of Pathology, Pakistan Institute of Medical Sciences. Islamabad.
Background: The term fresh frozen plasma (FFP) refers to the liquid portion of human blood which has been frozen and preserved quickly after a blood donation and later used for transfusion. The capitalized term Fresh Frozen Plasma is the proper name in the United States for the fluid portion of one unit of human blood that has been centrifuged, separated, and frozen solid at −18 °C (−0.4 °F) (or colder) within 6 hours of collection. Fresh frozen plasma is used in situation when oxygen carrying capacity of blood is not in question. The use of FFPs is now reserved for conditions requiring therapy in which
replacement of multiple plasma constituents are needed or for which the specific constituent is not commercially available in
purified injection or transfusion form. Plasma however contains numerous protein and chemicals which can be potentially
harmful. Therefore judicious use of plasma is extremely important where its benefits must outweigh its potential risks.
Although concrete guidelines are available for its optimum use, these guidelines are not strictly adhered to at some institutions. Mere knowledge is not sufficient and we often require auditing and periodic reinforcement to mould the clinical
practice in line with guidelines for appropriate and safe transfusion.
Material and Methods: The prospective review of FFPs transfusion request forms from different units of PIMS hospital at blood bank of PIMS during the months of September and October 2009 was done. We evaluated all FFP transfusions, classified them as appropriate or inappropriate according to the recent FFP transfusion guideline (College of American Pathologist 1994).
Results: During the study period, 100 cases were selected randomly. 64% of cases were considered inappropriate according to the guidelines. The most inappropriate requests were made by Burn Unit while the most appropriate requests were made by Thalasemia Center.
Conclusion: This study highlights the pitfalls in use of fresh frozen plasma among clinicians. The high rates of inappropriate transfusion reflect the lack of knowledge as well as non-adherence to the guidelines among clinicians, about the appropriate laboratory criteria as the basis for FFP usage for clotting support.
Keywords:Fresh Frozen Plasma (FFP), Coagulation Profile, Component therapy, Transfusion