Fresh frozen plasma
Fresh frozen plasma ( GFP , also FFP from English Fresh Frozen Plasma ) is a shock-frozen blood product obtained from the plasma of donor blood , which contains the liquid and dissolved components of the blood, while the corpuscular components (cells of the blood: erythrocytes , leukocytes , thrombocytes ) were largely removed by centrifugation.
ingredients
GFP contains in physiological concentration:
- Albumin, etc. a. Proteins
- Fibrinolysis Factors
- Factors of the complement system
- Clotting factors
- Immunoglobulins
storage
Fresh frozen plasma is stored deep-frozen and can be kept for up to two years at −30 to −45 ° C.
Indication for the administration of GFP
- Replacement of plasma in mass transfusions
- Replacement of coagulation factors V and XI (as these factors are not available individually as concentrates.)
- Hepatic insufficiency with insufficient formation of coagulation factors
- in the case of bleeding in the context of consumption coagulopathy (as long as there is no bleeding in the case of consumption coagulopathy, PPSB are more recommended.)
- Plasma replacement in plasmapheresis
dosage
One bag with GFP contains the coagulation factors of 500 ml whole blood from a donor. This corresponds to about 10% of the total amount of blood. After thawing, the coagulation activity has dropped to 70% of the original activity, after which it drops further within hours. Correspondingly, a canned GFP raises the coagulation factors of an adult by approx. 5–7 percentage points .
The rule of thumb is:
- 1 ml GFP / kg body weight leads to an increase in the coagulation factors of 1 to 2%.
Side effects
- Allergic reaction
- Risk of infection. However, the risk of infection is low compared to red cell concentrates because GFPs are stored in quarantine, ie they are only released when the donor has returned to donate blood a second time and again has no evidence of contagious diseases. However, quarantine storage only applies to those infections for which the donor is also examined after the end of quarantine storage (currently HIV, hepatitis B and C).
- Frozen plasma contains antibodies against blood group characteristics that the donor does not have (e.g. in the plasma of a donor in group A there are antibodies against blood group B). These antibodies react with the recipient's erythrocytes and hemolysis occurs . The more frozen plasma that is transfused, the more pronounced the reaction. For this reason, frozen plasma is AB0-compatible to transfuse. Group AB plasma is an exception as it does not contain antibodies according to the AB0 scheme.
