Rebecca Cardigan, BSc, PhD; Sheila Maclennan , MBBS, FRCP, FrCPath

Disclosures

Transfusion Alter Transfusion Med. 2008;10(3):92-101. 

In This Article

Preparation and Storage of Frozen-plasma Components

Plasma from whole blood donations or apheresis is used to either prepare plasma components for clinical transfusion or fractionate to produce pure plasma proteins.

FFP is produced by rapidly freezing the plasma removed from a whole-blood donation or collected by apheresis. This is usually performed within 8 hours of donation, in order to preserve the activity of coagulation factors V and VIII which are relatively labile. However, FFP can be produced from whole blood that has been stored at 4°C or 22°C for 24 hours. FFP is now only used to replace congenital single coagulation factor deficiencies where purified factor concentrates are not available (factors V and XI). Most FFP is used to treat acquired multiple coagulation factor deficiencies, usually in a clinical setting of massive transfusion, liver disease or disseminated intravascular coagulation.[9] Specifications of frozen-plasma component are given in Table 5 .

Cryoprecipitate is produced by slowly thawing FFP at 4°C. This causes the so-called cryoproteins to precipitate out: factor VIII, fibrinogen, von Willebrand factor (VWF), fibronectin and factor XIII. By centrifuging and removing the supernatant plasma, the cryoprecipitate left is a rich source of these proteins in a small volume of plasma. Because of the widespread availability of purified or recombinant concentrates of factor VIII and VWF, cryoprecipitate is rarely used in the developed world to replace these factors and is mainly used in the treatment of hypo- or dysfibrinogenemia. Because of its high fibrinogen content, cryoprecipitate is also used as a starting material for the production of fibrin glue.

The supernatant plasma removed from cryoprecipitate (CDP, cryoprecipitate-depleted plasma) has been used as a replacement fluid for plasma-exchange treatment of patients with thrombotic thrombocytopenic purpura (TTP), as an alternative to FFP. There are theoretical advantages of using CDP as it contains lower levels of high-molecular-weight multimers of VWF, but this benefit has not been proven clinically. In the UK, however, solvent-detergent-treated FFP is now recommended for the treatment of TTP because it is subject to pathogen inactivation during its manufacture and carries a lower risk of transfusion-related acute lung injury (TRALI) because of plasma pooling, which dilutes down the donor antibodies.

Frozen-plasma components can be stored for up to 36 months depending on the storage temperature, which is usually below -30°C. Once thawed, FFP should be used immediately but can be stored for up to 24 hours at 4°C.

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