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Table 28-3

Plasma Transfusion Indications

  • Management of bleeding or to prevent bleeding prior to an urgent invasive procedure in patients requiring replacement of multiple coagulation factors

  • Massively transfused patients who have clinically significant coagulation deficiencies and hypovolemia

  • Patients on warfarin therapy with bleeding or that need to undergo an invasive procedure before vitamin K could reverse the effects of warfarin or who need only transient reversal of warfarin effects

  • For transfusion or plasma exchange in patients with thrombotic thrombocytopenic purpura (TTP) and some cases of hemolytic uremic syndrome (HUS)

  • Management of patients with selected coagulation factor deficiencies, congenital or acquired, for which no specific coagulation concentrates are available

  • Management of patients with rare specific plasma protein deficiencies, when recombinant products or purified products are unavailable

  • Fresh frozen plasma (FFP) is the product of choice for patients specifically requiring replacement of the labile clotting factors or other proteins with poor storage stability because the other plasma products may be deficient in these factors during liquid storage; deficiencies due to consumption/hemodilution rarely fall to levels that are inadequately treated with non-FFP components; consultation with a hematologist or transfusion medicine physician is recommended for assistance with indications