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Plasma and plasma component therapy includes fresh frozen plasma, plasma, and cryoprecipitate. Although plasma is used extensively in many clinical applications that include coagulopathy and coagulation factor correction and surgical and traumatic bleeding resuscitation, data supporting its efficacy are limited. Plasma-based transfusions also pose multiple risks, including circulatory overload and transfusion-related acute lung injury. Indications for plasma and cryoprecipitate vary between countries, and the use of factor concentrates including prothrombin complex concentrates and fibrinogen are increasingly used as potential replacements. Strategies are available for pathogen reduction for plasma and plasma products, but additional cost and loss of factors are considerations for their use.



Plasma is the soluble protein containing solution of blood that contains the clotting factors, as listed in Table 140–1. There are multiple plasma products used clinically that include fresh frozen plasma (FFP), 24-hour plasma (FP24), thawed plasma, liquid plasma, solvent/detergent–treated plasma, and pathogen-reduced plasma.1 As per the FDA, except for liquid plasma and plasma cryoprecipitate–reduced, these products are all therapeutically equivalent, and throughout this chapter are simply termed plasma. Notably, the term FFP is used to encompass many of these products outside of the United States.

TABLE 140–1.Contents of Plasma, Cryoprecipitate, and Fibrinogen Concentrates

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