Presentation

• Fresh Frozen Plasma (FFP): 180-340mL
• Paediatric FFP: 45-90mL (4 doses can be obtained from a single donation)

ABO & RhD Compatibility

ABO

• Plasma components should be ABO compatible as follows:
• a group O patient can receive FFP of any ABO group
• a group A patient can receive A or AB FFP
• a group B patient can receive B or AB FFP
• a group AB patient can receive only AB FFP

Rh(D)

• No anti-D immunoglobulin need be given if Rh(D) negative patients receive Rh(D) positive FFP or cryoprecipitate.
• Although frozen plasma components may contain small amounts of red cell stroma, sensitisation following transfusion of Rh(D) positive units is most unlikely, as stroma is less immunogenic than intact red cells. Therefore Cryoprecipitate of any Rh(D) type may be given regardless of the Rh(D) type of the recipient. Contact Blood Bank if you are not sure.

Storage

• Once thawed, must be stored in an appropriately monitored (2-6°C) blood refrigerator according to Blood Bank standards for up to 24 hours.
• Never store in a drug or food fridge.
• If the transfusion can not be started within 30 minutes, return the component to a blood refrigerator Bank immediately for appropriate storage.
• Blood Bank will only accept the unit back into stock if returned within 30 minutes of issue from Blood Bank.
• Once issued, Fresh Frozen Plasma should be transfused as soon as possible.

Filter

• Use a standard blood infusion set which has a 170-200 micron filter
• ANZSBT guidelines require that blood giving sets must be changed when transfusion is completed or every 12 hours if the transfusion episode is not yet complete. This is intended to reduce the risk of bacterial growth occurring.
• Any number of red cell units may be transfused during a 12-hour period provided the flow rate remains adequate. However specific manufacturer's recommendations defining the maximum number of units per blood administration set must not be exceeded.
• A new blood administration set should be used if infusion of another fluid, medication or platelets is to continue after the current transfusion. This is intended to reduce the risk of incompatible fluids or drugs causing haemolysis of residual red cells in the administration set or drip chamber.
• Please consult your DHB blood policy for further details.
• All fresh components, including FFP, are leucodepleted at source by NZBS. No bedside leucodepletion is necessary.

Pump

• Approved infusion pump devices may be used.

Rate and Duration

• Paediatrics:
• in a non-bleeding patient: infuse at 10-20mL/kg/hr
• resuscitation: rapid infusion based on the patient's haemodynamics
• Adults:
• in a non-bleeding patient: most adults will tolerate one unit of FFP every 90 minutes. Consider a slower rate in patients with or at risk of congestive cardiac failure.
• resuscitation: rapid infusion based on the patient's haemodynamics
• Infusion of all components should be completed within 4 hours of leaving refrigerated storage.

Monitoring

• See page on Observations

DO NOT

• DO NOT add medication to FFP or Cryoprecipitate
• DO NOT use 5% Dextrose solutions (may induce haemolysis)
• DO NOT use Lactated Ringer's or other balanced salt solutions that contain Calcium, as this may induce clot formation in the blood bag and / or administration set.

Dose

• The standard therapeutic dose for Fresh Frozen Plamsa is 12-15mL per kg bodyweight.
• For paediatric patients, the dose should be written in mL, not units.
• See also ASTH warfarin reversal guidelines (2013) and Prothrombinex on Clotting Factors page.

Dose Calculator

More Info

• Patient Information Leaflet
• Datasheets
• Transfusion Medicine Handbook
• ANZSBT Guidelines on administering blood products
• NZBS Clinical Compendium
• Patient Blood Management guidelines