Fresh frozen plasma use in a tertiary referral hospital

Hospital transfusion practice is directed towards the optimization of transfusion therapy. A fresh frozen plasma (FFP) usage audit was performed on 316 consecutive FFP units, transfused in 119 transfusion episodes to 75 patients (January-April 1992). All patients had coagulation tests before and after FFP administration; 76% of the coagulation tests were abnormal and of the 24% patients with normal coagulation tests 83% required a massive blood transfusion. Prophylactic to therapeutic and surgical (pre, intra, post) to medical use was 48%:52% and 56%:44%, respectively. From 1988 to 1992 there has been a 42% fall in the hospital's usage of FFP and the FFP to red cell usage is 1:10. In this audit four groups of patients received FFP appropriately for the following indications: coagulation factor deficiency (40%); acute reversal of anticoagulation therapy (19%); massive blood transfusion (27%) and complex medical problems including intensive plasmapheresis (12%). Only 2 patients received FFP (4 units) inappropriately. A total of 98.7% of the FFP units were considered appropriately transfused.

Transfusion of frozen thawed blood stored at -20 degrees C to -25 degrees C

OBJECTIVE

To determine the clinical efficacy of transfusion of frozen-thawed (FT) red cells using a 5-bag system for freezing (at -20 degrees C to -25 degrees C), storage and reconstitution.

DESIGN

A prospective, controlled, non-randomised clinical trial was undertaken with two groups of orthopaedic surgical patients. Nine patients received FT homologous blood and a control group of 10 patients received homologous blood stored in liquid form at 4 degrees C. Five transfusion-dependent patients with medical conditions were also studied.

OUTCOME

Thirty-three FT units were transfused without incident to 14 patients. In addition to clinical assessment, haematological and biochemical parameters were monitored after transfusion. There were no clinical side effects and laboratory data were consistent with those after recent surgery or for pre-existing medical conditions and subsequent blood transfusion. On the practical side certain technical difficulties were encountered which improved with experience.

CONCLUSIONS

One of the major advantages of the system is the 35-day shelf-life at 4 degrees C after reconstitution. This system has potential for pre-deposit autologous collection, especially where large volume replacement may be required.