140 Using Plasma and Plasma Component Therapy Flashcards
Types of plasma products:
- Frozen plasma (FFP)
- 24-hour plasma (FP240
- Thawed plasma
- Liquid plasma
- Solvent/ detergent–treated plasma
- Pathogen-reduced plasma
As per the FDA, except for liquid plasma and plasma cryoprecipitate–reduced, these products are all therapeutically equivalent
Ways of plasma collection:
- Apheresis
- Manufactured from whole blood collections
To prepare frozen plasma for transfusion, the frozen product requires thawing at:
30–37 °C
Requires 20 to 30 minutes
After thawing, plasma is routinely stored at______ and transfused within ____ hours
1–6 °C
24 hours
Plasma that is not used within 24 hours can be relabeled as thawed plasma and stored for an additional 4 days at 1–6 °C.
Factor VIII activity will decrease about 50% at 5 days, the activity of factor V and factor VII decreases to approximately 20%, with the other factors remaining relatively stable.
TRUE OR FALSE
Plasma is not indicated if specific clotting factor concentrates, human or recombinant, are available.
TRUE
Plasma is not indicated if specific clotting factor concentrates, human or recombinant, are available.
They provide smaller volumes and are pathogen inactivated, improving their safety profile
TRUE OR FALSE
Plasma products can be ABO incompatible with the patient.
FALSE
Plasma products should be ABO compatible with the patient.
- Because of the negligible number of RBCs, plasma units do not need to be matched for RhD
- Frozen plasma does not need to be leukoreduced or irradiated.
During emergency situations type _____ can be transfused
AB
*A
Absence of anti-A and anti-B antibodies
Only 4% of the population is group AB, whereas 40% are group A
Defined as plasma that is frozen within eight hours of collection and stored at –18 °C or colder
Fresh frozen plasma
Defined as plasma frozen within 24 hours after collection but is stored at 1–6 °C within 8 hours of collection
FP24
Labeled as plasma frozen within 24 hours after phlebotomy
Product remaining after cryoprecipitate is removed from FFP
Plasma cryoprecipitate–reduced
Because factor VII, factor XIII, von Willebrand factor, and fibronectin are removed as cryoprecipitate, the product has adequate albumin; ADAMTS13; and factors II, V, VII, IX, X, and XI
The primary indication for plasma cryoprecipitate–reduced
Plasma exchange in patients with thrombotic thrombocytopenic purpura (TTP)
Made from whole blood and must be separated and infused no later than 5 days after the whole-blood expiration date and should be stored at 1–6 °C.
Liquid plasma
- Contains viable leukocytes so would need product modifications (leukoreduction or irradiation) before transfusion in at-risk individuals (eg, immunocompromised)
The only indication for liquid plasma
Initial treatment of patients undergoing massive transfusion as a result of massive hemorrhage
Methods of pathogen reduction
Occurs post manufacturing to reduce the risk of transfusion-transmitted infections and transfusion-associated graft-versus-host disease
Photochemical reductions include:
* Amotosalen (INTERCEPT Blood System, Cerus)
* Methylene blue (Theraflex, Macropharma)
* Riboflavin (Mirasol Pathogen Reduction Technology System, TerumoBCT)
Function by adding a photosensitizer followed by ultraviolet (UV) or visible light, and subsequent removal (except for Mirasol)
Only amotosalen with UV light is FDA approved.
With pathogen reduction, coagulation factor levels are decreased 30% to 40%, specifically:
FVIII, fibrinogen, and FXI
But may also include anticoagulant factors as well and reduce enveloped viruses
However, the ability to reduce nonenveloped viruses (eg, parvovirus B19, hepatitis E virus, hepatitis A virus) are variable.
