Screening and pathogen inactivation has reduced transmission rates of HIV to 1 in 7.8 million, hepatitis B virus to 1 in 153,000, and hepatitis C virus to 1 in 2.3 million. Infectious agents that are transmittable via fresh frozen plasma include HIV and hepatitis B and C. Non-immunologic complications include the transmission of infectious agents, transfusion-associated circulatory overload (TACO), and metabolic complications like citrate toxicity. They can be categorized into non-immunologic complications, immediate immunologic complications, and delayed immunologic complications. The acellularity of fresh frozen plasma spares certain disease transmission and blood immunogenicity: CMV and graft-versus-host disease cannot be transmitted by fresh frozen plasma as there are no viable leukocytes. The adverse effects of fresh frozen plasma administration are similar to those that pertain to whole blood and all blood components. After the initial dosage, re-administration may be needed every 6 to 8 hours if there is ongoing bleeding due to the short half-life of factor VII factor VII has a half-life of 2 to 6 hours. Once thawed, the activity of clotting factors, particularly factor V and factor VIII, decline gradually. If the thawed fresh frozen plasma is not used in 24 hours, it should be discarded. If fresh frozen plasma is not given immediately after thawing, it should be stored at 1 to 6 Celsius. Fresh frozen plasma should be administered immediately after thawing. Before administration, fresh frozen plasma is thawed in a water bath at 30 to 37 Celsius over 20 to 30 minutes or in an FDA-cleared device as quickly as 2 to 3 minutes. Fresh frozen plasma is stored at -30 Celsius. Upon visual inspection, the fresh frozen plasma container and fluid should have no leakage, clots, or abnormal color. Fresh frozen plasma must be ABO compatible with the recipient’s red cells. įresh frozen plasma can only be administered intravenously. Fresh frozen plasma transfusion may not be tolerated in patients with liver disease as patients may not tolerate the infusion volumes necessary to achieve adequate hemostatic levels of coagulation factors. Conditions that cause the deficiency of multiple coagulation factors and may require the administration of fresh frozen plasma include liver disease and disseminated intravascular coagulation. Other situations where the administration of fresh frozen plasma cannot be recommended for or against based on systematic review include fresh frozen plasma transfusion at a plasma-to-RBC ratio of 1 to 3 or more in trauma patients with massive transfusion. Based on a systematic review, other specific recommendations for fresh frozen plasma include trauma patients requiring massive transfusion and warfarin-related intracranial hemorrhage. Fresh frozen plasma is also indicated for a planned surgery or invasive procedure in the presence of abnormal coagulation tests, for the reversal of warfarin in the presence of active bleeding, or planned procedure when vitamin K is inadequate to reverse the warfarin effect, thrombotic thrombocytopenic purpura, and congenital or acquired factor deficiency with no alternative therapy. Fresh frozen plasma is indicated for the deficiency of coagulation factors with abnormal coagulation tests in the presence of active bleeding.
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