Fresh Frozen Plasma: Clinical Guidelines and Use

Abstract

Fresh frozen plasma (FFP) is the liquid portion of one unit of human blood that contains the labile and stable components of the coagulation, fibrinolytic and complement systems, as well as the proteins that maintain oncotic pressure and modulate immunity. The clinician must remember that a unit of single‐donor allogeneic plasma is a heterogeneous solution of proteins. Infusion of FFP normalizes abnormal tests efficaciously in patients with hereditary coagulopathies. However, its benefit in the treatment of excessive bleeding remains unclear and variable. In clinical practice, indication to transfuse FFP is based on a double threshold: a combination of abnormal coagulation tests plus excessive bleedings. FFP is not the first‐line option in the prevention of hemorrhage and in emergency reversal of oral anticoagulation for life‐threatening complications.