The Trends of Use of Fresh Frozen Plasma at a Tertiary Care Hospital

Abstract

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.