The role of plasma transfusion

With the development of medical technology, there are many distinctions in the treatment process of diseases that require blood transfusions. Whole blood is no longer directly transfused. Now whole blood, plasma and component blood are transfused according to the condition of the disease. Currently, diseases suitable for plasma transfusion include more serious liver diseases and burns. Before receiving plasma transfusion, you must obtain confirmation and consent from your doctor based on your situation.

Indications for plasma transfusion

(1) Severe liver disease:

This is one of the situations in which FFP is most often used. Liver disease can reduce the synthesis of coagulation factors, especially factors II, VII, IX, and X. Some patients with liver disease also have decreased fibrinogen, other coagulation factors, and thrombocytopenia. Deficiencies in these clotting factors can result in bleeding, requiring transfusions of FFP or normal frozen plasma or platelet concentrates as appropriate.

(2) Coagulation factor deficiency:

Congenital deficiency of a coagulation factor is rare, except for hemophilia A (lack of factor VIII) and hemophilia B (lack of factor IX). For the prevention and treatment of bleeding in the former, the most suitable products are cryoprecipitate (frozen or freeze-dried products) or concentrated factor VIII (medium purity or high purity). When these products are lacking, FFP can be used. For bleeding in hemophilia B, factor IX is best used; when this product is lacking, FFP or ordinary frozen plasma can be used. When surgery is performed on patients with either disease, especially major surgery, concentrated factor VIII or IX is used whenever possible. In the rare case of isolated factor V deficiency, FFP is the only available plasma. For other deficiencies such as factor II, VI, XI, and X, FFP or normal frozen plasma can be used.

(3) Disseminated intravascular coagulation (DIC).

(4)Burns.

(5) Antithrombin VII (AT VII) deficiency: FFP or ordinary frozen plasma can be used.

(6) Thrombotic thrombocytopenic purpura (TTP): FFP is often used for plasma exchange.

(7) Reversal of coumarin drug effects.

(8) First, vitamin K should be injected. The prothrombin time (PT) can be corrected within 6 to 12 hours. If time is insufficient, FFP or ordinary frozen plasma can be used at the same time. Plasma is mainly used to provide various coagulation factors. Its indications are shown in the table below. Indications for plasma transfusion Clinical conditions FFPFP Other conditions Severe liver disease Yes Yes PC Supplementation of coagulation factors Yes Yes Cryoprecipitate Factor VIII, IV Supplementation of AT III Yes Yes Coumarin reversal Yes Yes VK Massive transfusion As appropriate As appropriate PC Open heart surgery As appropriate PC Burns Yes Yes Severe trauma Yes Yes DIC Yes Cryoprecipitate plasma exchange (TTP, fulminant hepatitis)

Note:

FFP, fresh frozen plasma; FP, normal frozen plasma; VK, vitamin K; PC, platelet concentrate.

Contraindications:

No, COPD patients with heart failure cannot eat for a long time and cannot receive plasma transfusion, because the amount of transfusion is limited to reduce the patient's heart load. At this time, transfusion of plasma will increase the heart load.