Guidelines for frozen plasma transfusion

Guidelines based on a systematic literature review have been developed by the Transfusion Medicine Advisory Group of BC to provide physicians with evidence-based indications for transfusion of frozen plasma. Practices outlined in these guidelines are preferred to practices for blood product use based on anecdotal reports or personal experience, which may lead to unjustified exposure of patients to biological products as well as to overuse of scarce resources. The recommendations in the guidelines prepared by the Transfusion Medicine Advisory Group were graded according to the US Agency for Healthcare Research and Quality (formerly the US Agency for Health Care Policy and Research). At present, transfusion of frozen plasma is indicated for correction of known factor deficiencies for which no factor-specific concentrate is available, multiple-factor deficiencies associated with severe bleeding and/or disseminated intravascular coagulopathy, urgent reversal of warfarin effect, and for massive transfusion to maintain INR and PTT at less than 1.5 times the reference range. Frozen plasma is not indicated for a number of clinical situations, including hypovolemia, wound healing, and treatment of immunodeficiency states.