Judicious Transfusion of Fresh Frozen Plasma

Abstract

Background: Fresh Frozen plasma is prepared by centrifugation of whole blood or apheresis donation. It contains clotting factors, fibrinogen, anticoagulants, and certain electrolytes. FFPs are used worldwide for various indications, but their usage is mainly governed by clinical discernment rather than scientifically proven indications. Injudicious use of FFPs is not only a burden on resources but can also lead to adverse effects such as immune and non-immune mediated reactions, infections, and cardiopulmonary complications.

Objective: The objective of this study was to assess the judicious transfusion of fresh frozen plasma.

Methodology: After approval from the Aga Khan University Ethics Review Committee, medical record numbers for patients transfused with FFP's between the period October 2021 and December 2021 were extracted. Details including demography, reason for transfusion, admitting department and coagulation profile were acquired for every patient. Transfusion indications were decided as appropriate or inappropriate in view of British Committee for the Standards in Haematology (BCSH) guidelines. Data was then analyzed in SPSS v26.

Results: A total number of 310 patients were transfused FFPs between the study period, which accounted for a total of 1201 units. Age was distributed between 0 days to 81 years. Majority of the transfusions were performed by the department of Gastroenterology (14.2%), whereas adults and pediatric critical care contributed 11.6% and 8.1% respectively. Major diagnosis included sepsis (27.7%), malignancy (17.7%) and liver disease (17.4%). Most common indication revealed was deranged INR with active bleeding (28.4%). Out of the total transfusions, 68.4% of the transfusions were appropriate, leaving out 31.6% to be without a strong indication.

Conclusion: This analysis revealed a lack in judicious transfusion of fresh frozen plasma. These results can urge clinicians to make decision wisely for transfusion on the basis of research-based guidelines and evidence.