Makindo Medical Notes Comprehensive Medical Encyclopedia | Education for Healthcare Professionals

🧪 Fresh Frozen Plasma (FFP) contains stable clotting factors, albumin, and immunoglobulins, and is widely used for patients with coagulation disorders. It is a key supportive therapy in bleeding, liver disease, and massive transfusion protocols.

ℹ️ About

🩸 FFP is the liquid component of whole blood after removal of red cells, white cells, and platelets. It is rich in clotting factors and plasma proteins that maintain coagulation and fluid balance.
❄️ Separated and frozen within 6 hours of donation at –25 °C to preserve labile factors (notably Factor V and VIII).
📦 Storage: up to 1 year at –25 °C or lower. Once thawed:
- ⏱️ Use within 24 hours if kept at 2–6 °C
- ⏱️ Within 30 minutes if left at room temperature
⚖️ Typical volume: 200–300 mL per unit. Adult dose = 10–15 mL/kg (~1 L in a 70 kg adult).
🎯 Goal: Normalise coagulation (aim INR ≤ 1.7, PT < 1.5, or APTT < 2× normal).
🧬 Contains:
- All clotting factors (II, V, VII, VIII, IX, X, XI)
- Fibrinogen
- Albumin (oncotic support)
- Immunoglobulins (immune defense)

🎯 Indications for FFP Transfusion

🩸 Coagulopathy with active bleeding – e.g. liver failure, DIC.
📊 Prolonged PT/APTT with bleeding – PT > 1.5, INR > 2, or APTT > 2× normal.
💊 Warfarin reversal – if PCC unavailable or contraindicated.
🚑 Massive transfusion – to correct dilutional coagulopathy.
⚡ DIC with bleeding – replace depleted clotting factors.
🧩 TTP (plasma exchange) – provides ADAMTS13.
🧬 Inherited factor deficiencies (e.g. Factor V/XI) when concentrates not available.
🫀 Liver disease – to prevent/treat bleeding pre-procedure.
🧾 ABO compatibility: must match patient. AB plasma is the universal donor; O plasma only to O recipients.

🚫 Contraindications

💧 Volume overload (caution in HF/CKD).
🤧 Allergic reactions – rare, can be severe.
⚠️ Correcting mild abnormal clotting tests without bleeding – not indicated.

⚠️ Risks and Complications

🤧 Allergy: from urticaria → anaphylaxis.
🫁 TRALI: immune-mediated lung injury, acute hypoxia within 6 hrs.
💦 TACO: circulatory overload → pulmonary oedema, especially in elderly/frail.
🦠 Infection risk: very low due to screening, but not zero.

📊 Comparison: FFP vs Cryoprecipitate

Characteristic	Fresh Frozen Plasma (FFP)	Cryoprecipitate (Cryo)
Composition	All clotting factors, fibrinogen, albumin, immunoglobulins, plasma proteins	Fibrinogen, Factor VIII, vWF, Factor XIII, fibronectin
Volume	200–300 mL/unit	10–20 mL/unit (pooled 5–10 units)
Storage	–25 °C, 1 year. Use within 24h if refrigerated, 30 min if RT	–25 °C, 1 year. Use within 6h once thawed
Primary Use	Broad replacement of coagulation factors	Targeted fibrinogen replacement
Indications	Coagulopathy + bleeding Warfarin reversal (if PCC unavailable) Massive transfusion Liver disease coagulopathy DIC with bleeding TTP	Fibrinogen <100 mg/dL in bleeding Massive transfusion Factor XIII deficiency Liver disease with bleeding DIC with bleeding
Contraindications	Fluid overload Allergy TRALI risk No active bleeding	Fluid overload Allergy TRALI risk
Dosing	10–15 mL/kg (≈3–4 units in adult)	10 units ↑ fibrinogen by ~0.7 g/L

Fresh Frozen Plasma

ℹ️ About

🎯 Indications for FFP Transfusion

🚫 Contraindications

⚠️ Risks and Complications

📊 Comparison: FFP vs Cryoprecipitate

📚 References

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