Blood Product: Fresh Frozen Plasma (FFP) is a blood product derived from whole blood donation. It is the liquid portion of the blood that is frozen within a specific timeframe (usually 8 hours) after collection.
Composition: FFP contains all the essential plasma proteins, including the full complement of coagulation factors, natural anticoagulants (like protein C and S), and albumin.
Storage and Thawing: FFP is stored at very low temperatures (typically below −18∘C) to preserve the activity of the labile coagulation factors. It must be thawed just prior to transfusion.
Compatibility: ABO compatibility is essential for FFP transfusion to prevent reactions, as the plasma contains antibodies (e.g., anti-A and anti-B).
Advantages
Broad Coagulation Factor Replacement: FFP is the only readily available blood product that contains all coagulation factors, making it a powerful and versatile tool for correcting multiple factor deficiencies.
Rapid Action: It provides immediate and complete replacement of clotting factors, which can quickly reverse a coagulopathic state and control bleeding.
Source of Natural Anticoagulants: In addition to clotting factors, FFP contains natural anticoagulants like Protein C, Protein S, and Antithrombin, which can be beneficial in certain conditions like sepsis or liver disease.
Volume Expansion: FFP can also be used as a volume expander in hypovolemic patients, especially those who require simultaneous correction of a coagulopathy.
Uses
Treatment of Massive Hemorrhage: A primary indication for FFP is in the management of massive bleeding, such as in severe trauma or major surgery, to replenish depleted clotting factors.
Reversal of Warfarin Effect: It is used to rapidly reverse the anticoagulant effect of warfarin when immediate surgery or an emergency is required and Vitamin K or other specific reversal agents are not fast enough or available.
Liver Disease: Indicated for patients with liver disease who are bleeding or undergoing invasive procedures, as the liver is responsible for synthesizing most coagulation factors.
Rare Congenital Factor Deficiencies: Used for the treatment of bleeding in patients with rare congenital deficiencies of specific clotting factors for which a more specific factor concentrate is not available.
Nature
Source Material: FFP is prepared from the plasma component of whole blood or from apheresis donations.
Mechanism of Action: The therapeutic effect of FFP is to replenish depleted coagulation factors, natural anticoagulants, and other plasma proteins. This restores the patient’s ability to form a stable blood clot, thus stopping or preventing hemorrhage.
Risk of Transfusion Reactions: As a blood product, FFP carries a risk of transfusion-related reactions, including allergic reactions, Transfusion-Related Acute Lung Injury (TRALI), and Transfusion-Associated Circulatory Overload (TACO).
Viral Inactivation: While modern FFP is screened for common viruses, it carries a small residual risk of transmitting infectious diseases. Pathogen-reduced FFP products are now available in some regions to mitigate this risk.
Storage
Frozen State: Fresh Frozen Plasma must be stored at or below −18∘C (and preferably below −25∘C) to maintain the activity of labile clotting factors, particularly Factors V and VIII.
Shelf Life: In this frozen state, FFP has a shelf life of up to one year from the date of collection.
Thawing Process: It must be thawed in a controlled manner (e.g., in a 30−37∘C water bath) immediately before use. Once thawed, it should be transfused as soon as possible.
Post-Thaw Shelf Life: After thawing, FFP is only stable for a limited time (typically up to 24 hours if refrigerated at 1−6∘C) before its labile clotting factors degrade. It should never be re-frozen.
