What is the role of plasma in preventing heterologous transfusions in liver transplantation?

Updated: Apr 19, 2019
  • Author: Vanessa A Olcese, MD, PhD; Chief Editor: Ron Shapiro, MD  more...
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Coagulopathy remains a serious complication of liver disease and transplantation. Fresh frozen plasma (FFP) is used to correct deficiencies in plasma coagulation factors, but it carries a risk of viral transmission. When FFP is needed, it can be treated with solvent-detergent to inactivate viral particles.

Treated plasma has lower factor VIII and alpha-2 antiplasmin activity, but patients who receive treated FFP demonstrate a similar correction of the international normalized ratio (INR) and activated partial thromboplastin time (aPTT), and they have transfusion requirements similar to those of patients who receive untreated FFP. [45] Patients who receive treated FFP also have a decreased risk of viral infection. However, until further studies are performed, treated plasma should be used with caution during OLT in light of a recent report that suggested increased fibrinolysis with the use of solvent-detergent–inactivated plasma. [46]

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