Korean J Hematol 2010; 45(3):
Published online September 30, 2010
https://doi.org/10.5045/kjh.2010.45.3.152
© The Korean Society of Hematology
The Institute for Transfusion Medicine, Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA.
Correspondence to : Correspondence to Mark H. Yazer, M.D., FRCPC. The Institute for Transfusion Medicine, 3636 Blvd of the Allies, Pittsburgh, PA, USA. Tel: +1-412-209-7522, Fax: +1-412-209-7325, myazer@itxm.org
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Although traditionally fresh frozen plasma (FFP) has been the product of choice for reversing a significant coagulopathy, the modern blood bank will have several different plasma preparations which should all be equally efficacious in reversing a significant coagulopathy or arresting coagulopathic bleeding. Emerging evidence suggests that for a stable patient, transfusing plasma for an INR≤1.5 does not confer a hemostatic benefit while unnecessarily exposing the patient to the risks associated with plasma transfusion. This review will discuss the various plasma products that are available and present some of the current literature on the clinical uses of plasma.
Keywords Fresh frozen plasma, FFP, FP24, Plasma, Evidence, Transfusion, INR, PTT
Korean J Hematol 2010; 45(3): 152-157
Published online September 30, 2010 https://doi.org/10.5045/kjh.2010.45.3.152
Copyright © The Korean Society of Hematology.
Mark H. Yazer*
The Institute for Transfusion Medicine, Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA.
Correspondence to: Correspondence to Mark H. Yazer, M.D., FRCPC. The Institute for Transfusion Medicine, 3636 Blvd of the Allies, Pittsburgh, PA, USA. Tel: +1-412-209-7522, Fax: +1-412-209-7325, myazer@itxm.org
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Although traditionally fresh frozen plasma (FFP) has been the product of choice for reversing a significant coagulopathy, the modern blood bank will have several different plasma preparations which should all be equally efficacious in reversing a significant coagulopathy or arresting coagulopathic bleeding. Emerging evidence suggests that for a stable patient, transfusing plasma for an INR≤1.5 does not confer a hemostatic benefit while unnecessarily exposing the patient to the risks associated with plasma transfusion. This review will discuss the various plasma products that are available and present some of the current literature on the clinical uses of plasma.
Keywords: Fresh frozen plasma, FFP, FP24, Plasma, Evidence, Transfusion, INR, PTT
Theoretical relationship between concentration of coagulation factors and PT/INR. Based on the experience with single factor deficiencies, coagulation proceeds normally until the concentration of factors drops below 30%. Thus there is a significant reserve of clotting factors (the physiologic reserve). Also note that abnormal clotting times can occur while the levels of clotting factors are still within the physiologic reserve, another reason why the PT/INR does not necessarily predict peri-operative bleeding. Refer to text for explanation of the labels. Modified and reprinted from reference [23], with permission from the AABB.
PT values in healthy individuals who first received oral anticoagulation, then 1 L of autologous plasma, then oral vitamin K at the end of the study. Note how the FFP produced only a partial correction of the elevated PT
Theoretical response to plasma transfusion based on a formula derived from a clinical study of 140 adult plasma recipients [28]. The main predictor of the response to plasma transfusion is the pretransfusion INR.
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Theoretical relationship between concentration of coagulation factors and PT/INR. Based on the experience with single factor deficiencies, coagulation proceeds normally until the concentration of factors drops below 30%. Thus there is a significant reserve of clotting factors (the physiologic reserve). Also note that abnormal clotting times can occur while the levels of clotting factors are still within the physiologic reserve, another reason why the PT/INR does not necessarily predict peri-operative bleeding. Refer to text for explanation of the labels. Modified and reprinted from reference [23], with permission from the AABB.
|@|~(^,^)~|@|PT values in healthy individuals who first received oral anticoagulation, then 1 L of autologous plasma, then oral vitamin K at the end of the study. Note how the FFP produced only a partial correction of the elevated PT
Theoretical response to plasma transfusion based on a formula derived from a clinical study of 140 adult plasma recipients [28]. The main predictor of the response to plasma transfusion is the pretransfusion INR.