Guidelines for frozen plasma transfusion

311 ABSTRACT: Guidelines based on a systematic literature review have been developed by the Transfusion Medicine Advisory Group of BC to provide physicians with evidencebased indications for transfusion of frozen plasma. Practices outlined in these guidelines are preferred to practices for blood product use based on anecdotal reports or personal experience, which may lead to unjustified exposure of patients to biological products as well as to overuse of scarce resources. The recommendations in the guidelines prepared by the Transfusion Medicine Advisory Group were graded according to the US Agency for Healthcare Research and Quality (formerly the US Agency for Health Care Policy and Research). At present, transfusion of frozen plasma is indicated for correction of known factor deficiencies for which no factor-specific concentrate is available, multiplefactor deficiencies associated with severe bleeding and/or disseminated intravascular coagulopathy, urgent reversal of warfarin effect, and for massive transfusion to maintain INR and PTT at less than 1.5 times the reference range. Frozen plasma is not indicated for a number of clinical situations, including hypovolemia, wound healing, and treatment of immunodeficiency states. T he Transfusion Medicine Advisory Group (TMAG) of BC has prepared guidelines to assist physicians in their clinical decision-making regarding the appropriate use of frozen plasma products in adults and neonates. These guidelines are available electronically on the British Columbia Provincial Coordinating Office web site (www.bloodlink.bc.ca) and will be updated periodically. Prescribing physicians are responsible for referring to the most recent guidelines, which are intended to guide therapy but are not intended to replace the clinical judgment of the attending physician and appropriate consultation with an expert in transfusion medicine.