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Fresh Frozen Plasma

For as long as I can remember, the transfusion service has released fresh frozen plasma (FFP) to treat emergent or chronic bleeding secondary to liver disease coagulopathy, vitamin K deficiency, DIC, warfarin overdose rescue, or single factor deficiencies for which no single factor concentrates were available; prothrombin, V, VII, X.

FFP is supernatant plasma expressed from centrifuged whole blood and frozen within eight hours of collection. However, FFP usage is diminishing as we change to FP24. What is FP24?

FP24 is supernatant plasma expressed and frozen 8 to 24 hours after collection. In 8/4/08 discussions with Margaret G. Fritsma, MA, MT (ASCP) SBB, lead AABB assessor, and Ken Mc Milin, MD, Medical Director for the Birmingham and Central Gulf Coast Red Cross Blood Services, I learned that most component preparation centers now produce FP24 in place of FFP. This reduces the administrative burden and cost, particularly as transfusion-related acute lung injury (TRALI) has made it necessary to identify components as from males or females. [TRALI is most often associated with plasma products from women.] The task of sorting male from female plasma products adds significantly to preparation time.

Institutions have accepted this change readily, because a number of studies have reported no reduction in factor activity except for factor VIII. Factor VIII activity drops by 15% in the first eight hours following collection when the blood is stored at 1-6 degrees C, and by another 15% between eight and 24 hours. Of course, frozen plasma is not indicated for factor VIII deficiency, as virus-free synthetic factor concentrates are available.

I always thought that thawed plasma was good for up to 24 hours. I learned from these experts that once FFP or FP24 is thawed, it may be used for up to five days following initiation of thawing provided it is maintained at 1-6 degrees C and is not breached. After the first 24 hours it is relabeled “Thawed Plasma” but it is nonetheless available for all inidcated therapeutic purposes for four more days. Geo

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