Analysis of Appropriateness and Efficacy of Fresh Frozen Plasma Transfusion

Kang, Su Gyoung; Kwon, Seog Woon

Abstract

BACKGROUND: This study was performed to analyze the appropriateness and the efficacy of fresh frozen plasma (FFP) transfusions for the treatment of coagulopathy.
METHODS
Three hundred and eleven patients with FFP transfusion histories were evaluated on the state of coagulopathy and the reasons for transfusion. The reasons were classified according to the recommendations by the British Committee for Standards in Haematology (BCSH) for evaluation of transfusion appropriateness. The efficacy of transfusions was evaluated in 144 patients with coagulopathy by means of delta PT (%) and delta aPTT (sec). Corrected delta PT (c delta PT) and corrected delta aPTT (c delta aPTT) were defined as delta PT and delta aPTT divided by the transfusion amount, and these were compared among the disease groups.
RESULTS
Forty-two patients (30.5%) were definitely indicated, and 53 patients (17.0%) were conditionally indicated. One hundred and eighty-four patients (59.2%) were transfused with no justification for the transfusions. Of the improved cases, 27.8% of the patients scored at more than 10% in the PT (%) category. In 28.1% of the patients, there were more than 10 sec in aPTT (sec). There was a significant correlation between the volume of the transfusion (mL/kg) and the delta PT and delta aPTT (r=0.2932, P=0.0004; r=0.2379, P=0.0047; respectively). The c delta PT had an inverse correlation to the elapsed time from transfusion to the coagulation assay (r=-0.1815, P=0.0301). The c delta PT and the c delta aPTT were significantly lower in patients with liver disease than those with DIC (P=0.0009, P=0.0084; respectively).
CONCLUSIONS
We found that FFP was transfused more inappropriately than should have been. The transfusion volume was the most significant factor for the efficacy of FFP transfusions. FFP transfusions were less efficient in the patients with liver disease.