Plasma and cryoprecipitate for transfusion

Plasma for transfusion can be collected through centrifugation of whole blood or by plasma apheresis. It can then be stored frozen as fresh-frozen plasma (FFP) or used to produce more purified constituents, including cryoprecipitate, concentrates of coagulation factors and fibrin sealant, immunoglobulins, anticoagulants, complement related proteins, and albumin. Clinical use of FFP has been maintained over the last two decades in many countries, although the defining characteristic of plasma transfusion is wide variation in transfusion rates. The chapter also discusses the role of plasma transfusion to prevent bleeding (prophylactic) and the use of plasma transfusion in the absence of bleeding to correct abnormal clotting tests. Prothrombin complex concentrates are considered the product of choice in several countries for reversal of warfarin over-anticoagulation in patients who are bleeding or undergo urgent surgery or invasive procedures. Cryoprecipitate is a source of concentrated fibrinogen, and its use is largely focused on patients with clinical bleeding and low-fibrinogen concentrations.