Fresh Frozen Plasma – Uses and Risks

A while back doctors used to transfuse whole blood to their patients but now with advanced studies and invention of sophisticated equipment it has become possible to become more judicious in the use of blood. Now doctors separate different components of the blood and use them for curing different problems and only transfuse that portion in the patient which he needs. This way nothing goes to waste and less blood can be used to cure more people.

Fresh frozen plasma came to be used for the first time during Second World War. World Health Organization (WHO) has a List of Essential Medicines, and fresh frozen plasma is present on that list.

Fresh frozen plasma is the liquid portion of the blood that has been separated from the blood cells. It is called fresh frozen plasma because it is frozen less than eight hours after the extraction. It is frozen at a temperature of 0 °F which translates to −18 °C. It consists of proteins, carbohydrates, fats and vitamins present in the blood along with water.

Plasma is separated from the blood with the help of a centrifuge. Centrifuge is a machine that separates different parts of a liquid according to their densities. It operates on the principle of centrifugal force. Plasma is separated by a centrifuge and then collected. After freezing at the proper temperature it becomes fresh frozen plasma or FFP. It lasts for about a year if frozen properly.

Fresh frozen plasma is usually used to cure disorders associated with low protein content in blood or where there is an insufficient number of blood clotting factors present in blood. Fresh frozen plasma can be used to increase the volume of blood but its use as such is not recommended. Fresh frozen plasma is intravenously injected into the blood.

Fresh frozen plasma can be used for the following purposes:

Fresh frozen plasma is used to treat the deficiency of factor V. Apart from that it is also used to treat the deficiency of factors II, VII, X, IX and XI when specific component therapy cannot be done. The treatment of deficiency depends on the factor. Some of them can be easily treated with fresh frozen plasma alone while others are more difficult to achieve with only fresh frozen plasma.

Functional vitamin K dependent factors II, VII, IX and X as well as protein C and S are deficient in people who have been treated with warfarin which is an anticoagulant drug. This deficiency can be treated by giving the patient vitamin K. if the patient requires immediate surgery or if he is bleeding profusely, he can be given fresh frozen plasma but only if no other alternative method is available.

If the patient has a deficiency of the inhibitor antithrombin III and he is undergoing surgery, then fresh frozen plasma can be given to that patient. Fresh frozen plasma can also be given to a patient who is in need of heparin to treat thrombosis.

People suffering from humoral immunodeficiency can be given fresh frozen plasma as a source of immunoglobulin even though this practice is somewhat reduced due to the availability of purified immunoglobulin that can be injected intravenously.

Infants who are suffering from secondary immunodeficiency due to severe protein losing enteropathy can be given fresh frozen plasma but only when other injected nutrition has proved to be ineffective.

Thrombotic thrombocytopenic purpura or TTP can also be treated by the transfusion of fresh frozen plasma.

There are a few risks associated with fresh frozen plasma. Some of them are mentioned here:

• Transfusion of fresh frozen plasma can lead to transmission of various diseases especially blood borne diseases.
• Transfusion of fresh frozen plasma can also cause anaphylactic shock which is an extreme allergic reaction. This is a life threatening reaction which may lead to death. Other symptoms of anaphylactic shock include swelling of tongue and throat, vomiting, rashes, itching and headache etc.
• Giving a patient fresh frozen plasma can also lead to increased intravascular volume which means an increase in the volume of the blood in the circulatory system of the body which can lead to various problems.
• Transfusion related acute lung injury is also one of the risks associated with fresh frozen plasma transfusion. Transfusion relation acute lung injury is a complication related to blood transfusion and causes pulmonary edema.
• Fresh frozen plasma transfusion also causes an increase in infections including infection of surgical wounds.
• The risk of viral infection is similar to that of whole blood transfusion or red blood cells transfusion.
• Allergies are also a risk related with fresh frozen plasma transfusion. These may be common one like rashes, hives, itching etc. or quite severe such as fatal non-cardiogenic pulmonary edema.
• There is also a risk of transmission of HIV or human immunodeficiency virus through fresh frozen plasma transfusion.
• Even though it rarely occurs, there is a risk of agglutination so the fresh frozen plasma should be matched according to blood type to ensure compatibility.
• If excessive amount of fresh frozen plasma is given to a patient, there is a risk of hypovolemia also known as fluid overload and cardiac failure.
• There is also a risk of post-transfusion hepatitis occurring in the patient transfused with fresh frozen plasma.