Indications

NICE state with respect to use of fresh frozen plasma (1)

Thresholds and targets

Fresh frozen plasma transfusion for patients should only be considered with clinically significant bleeding but without major haemorrhage if they have abnormal coagulation test results (for example, prothrombin time ratio or activated partial thromboplastin time ratio above 1.5).

Do not offer fresh frozen plasma transfusions to correct abnormal coagulation in patients who:

• are not bleeding (unless they are having invasive procedures or surgery with a risk of clinically significant bleeding)
• need reversal of a vitamin K antagonist

Consider prophylactic fresh frozen plasma transfusions for patients with abnormal coagulation who are having invasive procedures or surgery with a risk of clinically significant bleeding.

Notes:

• some other suggested indications include: Absolute: Relative:
  • previously used for immediate reversal of warfarin effect - note now that prothrombin factor concentrate (often with intravenous vitamin K) is used
  • acute disseminated intravascular coagulation
  • thrombotic thrombocytopaenic purpura
  • replacement of single coagulation factor deficiencies where a specific or combined factor concentrate is unavailable for example, deficiencies of Factor V, VII, X, XI, XII, or von Willebrand's disease
  • bleeding or disturbed coagulation associated with:
    • massive transfusion
    • liver disease
    • cardiopulmonary bypass surgery
  • major burns in children

Reference:

• NICE (November 2015). Blood transfusion