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Risks of fresh frozen plasma and platelets
Sheila MacLennan1, Lorna M Williamson
1National Blood Service, Leeds Centre, England.
The Journal of Trauma
|June 10, 2006
Summary
Fresh frozen plasma (FFP) and platelets are vital in massive transfusions but carry risks like allergic reactions and transfusion-related acute lung injury (TRALI). Pathogen reduction technologies are improving the safety of these blood components.
Area of Science:
- Transfusion Medicine
- Hematology
- Immunology
Background:
- Fresh frozen plasma (FFP) and platelets are extensively used in massive transfusion protocols.
- While FFP can partially correct coagulation, randomized trials demonstrating clinical benefit are lacking.
- FFP and platelets are associated with risks including immunologic reactions (allergy, TRALI) and hemolysis.
Purpose of the Study:
- To review the safety and efficacy of fresh frozen plasma and platelet transfusions.
- To discuss emerging risks and mitigation strategies for blood components.
- To highlight advancements in pathogen reduction technologies for transfusion safety.
Main Methods:
- Systematic review of randomized trials for FFP efficacy.
- Analysis of transfusion-related adverse events associated with FFP and platelets.
- Review of current and emerging pathogen reduction methods (solvent detergent, methylene blue, amotosalen).
Main Results:
- No randomized trials show clinical benefit for FFP in massive transfusion.
- Transfusion-Related Acute Lung Injury (TRALI) is a significant cause of transfusion-related death, often linked to donor HLA antibodies.
- Platelet safety is enhanced by additive solutions and pathogen reduction, which also reduces bacterial contamination risk.
Conclusions:
- Selecting non-immune donors for FFP may reduce TRALI risk.
- Platelet additive solutions and pathogen reduction significantly improve component safety.
- Pathogen reduction technologies are crucial for minimizing infectious and non-infectious risks in transfusion medicine.
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