Presentation
- Thawed Plasma (Thawed Plasma): 180-340mL
- Paediatric FFP: 45-90mL (4 doses can be obtained from a single donation)
- Please note that some blood banks in New Zealand are using FFP (24 hour shelflife) and some are using FFP-EL (120 hour shelflife).
Blood banks using FFP-EL are: Auckland, Christchurch, Dunedin, MidCentral, Middlemore, Tauranga, Waikato, Wellington.
ABO & RhD Compatibility
ABO
- Plasma components should be ABO compatible as follows:
- a group O patient can receive Thawed Plasma of any ABO group
- a group A patient can receive A or AB Thawed Plasma
- a group B patient can receive B or AB Thawed Plasma
- a group AB patient can receive only AB Thawed Plasma
- an unknown group patient can receive only AB or low titre group A Thawed Plasma
- Emergency Thawed Plasma is supplied as AB or low-titre A
Rh(D)
- No anti-D immunoglobulin need be given if Rh(D) negative patients receive Rh(D) positive Thawed Plasma 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
- Thawed Plasma (120), once thawed, must be stored in an appropriately monitored (2-6°C) blood refrigerator according to Blood Bank standards for up to 120 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, Thawed Plasma should be transfused as soon as possible.
Filter
- Use a standard blood infusion set which has a 170-200 micron filter
- One administration set may be used for administration of 2-4 units of red blood cells provided the flow rate remains adequate. In a massive transfusion situation, 8-10 units may be transfused before the set is changed, providing that the set is changed every 8 hours. Platelets should only be administered through a new blood giving set.
- All fresh components, including Thawed Plasma, 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 Thawed Plasma 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 Thawed Plasma 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 Thawed Plasma 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.
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