Expanded use of liquid plasma in non-emergency transfusions: A single academic institution experience

Liquid plasma (LP) is isolated from whole blood donations, never frozen, and can be immediately transfused. Its primary indication is initial treatment of patients undergoing massive transfusion. To minimize wastage of this resource, we expanded the use of LP to include surgical and routine transfusions.

Our medical record was queried for plasma transfusions with at least one unit of LP issued. Chart review identified the indications for transfusion (emergency use, surgical use, or routine transfusion) and assessed effects of LP on coagulopathy, the use of additional blood products, and mortality. LP cases were categorized into two groups based on the fraction of LP transfused (≤50% or >50% LP). A control group of routine transfusion using only thawed plasma (TP) was reviewed and statistically compared to those cases where LP was included.

Eight hundred ninety cases were studied including 34% emergency/massive transfusion events, 44% surgical cases, and 11% routine transfusions. In surgeries using LP, there were no significant differences in outcomes based on higher fractions of LP transfused. The correction of coagulopathy, the need for additional blood products, and the encounter-specific mortality were consistent across both routine transfusions with higher fractions of LP and comparing LP transfusion events to control TP transfusion events.

The utilization of LP in surgical cases and routine plasma transfusions was not associated with worse clinical outcomes and effectively prevented product waste. This report supports the broader use of and further study of LP in patient care.