Plasma Dosage
Doses plasma for transfusion in patients with active bleeding.
This dosing tool is intended to assist with calculation, not to provide comprehensive or definitive transfusion information. Always double-check dosing of any drug and consult a pharmacist or clinical pathologist as necessary.
Absolute contraindications to transfusion of fresh frozen plasma (FFP): documented intolerance to plasma or components, congenital IgA deficiency with anti-IgA antibodies, etc. Relative contraindications: heart failure, pulmonary edema, etc. Plasma should be ABO-compatible with recipient.
Advice
- Adverse reactions to the transfusion of FFP include:
- Allergic reactions:
- Mild (urticaria): occur in 1% of patients.
- Severe and anaphylactic: occur with a frequency of <1 case per 100,000 transfusions. Risk for this complication may be reduced by using plasma from male donors who have never been transfused and from nulliparous female donors who have never been transfused, or by using solvent/detergent (S/D) FFP.
- Transfusion-related acute lung injury (non-cardiogenic pulmonary edema developing within 4–6 hours of the transfusion of FFP). As with anaphylaxis (above), risk may be reduced by using plasma from male or nulliparous female donors who have never been transfused or by using S/D FFP.
- Febrile reactions: occur in <1% of patients transfused with FFP and in up to 10% of patients undergoing plasma exchange.
- Citrate toxicity: can occur after the rapid transfusion of large volumes of plasma and is particularly important in neonates and in patients with liver disease.
- Transmission of infections: the process of freezing inactivates bacteria. Bacterial contamination and growth with release of endotoxins before freezing is extremely improbable. There is, however, still minimal risk of transmission of viral infections or infections due to other unknown or untested pathogens.
- Circulatory overload: can occur, particularly in patients with renal or cardiorespiratory failure.
- Inhibitors against deficient proteins: can develop after transfusion of plasma in patients with severe deficiencies of clotting factors.
- Graft-versus-host disease (GvHD): no known cases of FFP-associated GvHD have been reported. Freezing causes lysis of lymphocytes, so irradiation of the plasma is not necessary.