Plasma is the liquid matrix of blood in which the red cells are suspended and also contains the factors for blood coagulation. There are five main types of plasma transfusion: fresh, frozen plasma (FFP), human albumin, cryoprecipitate, freeze-dried Factor VIII concentrate, and freeze-dried Factor IX-prothrombin complex. Protein C and immuglobulin are also components of plasma that are transfused.
FFP is plasma that has been removed from a donor and rapidly frozen. This product is used to replace coagulation factor deficiencies and to reverse the effects of wafarin, an anticoagulant medication. Doctors also use FFG for patients who have had large blood transfusions to replenish the balance between plasma and red cells. Patients with liver disease, thrombotic thrombocytopenic purpura (TTP), and disseminated intravascular coagulation (DIC), along with those who have undergone cardiopulmonary bypass surgery, also benefit from FFP.
Human albumin is used as a plasma volume expander to restore blood volume in patients who have had theirs reduced due to trauma, burns, or surgical procedures. This type of plasma transfusion can treat patients who have hypoalbuminemia, nephrotic syndrome, liver failure, or who are undergoing plasmapharesis. Albumin is ideal in situations when the patient requires a transfusion, but minimal amounts of electrolytes are desired.
Cryoprecipitate is FFP with the majority of the plasma matrix removed. The remaining solution contains concentrated amounts of coagulation Factor VIII, Factor XIII, and von Williebrand factor (vWF) in addition to fibrinogen and fibronectin. This type of plasma transfusion works as blood coagulation factor replacement therapy for people with hemophilia, von Williebrands disease, DIC, or hypofibrinogenanemia. This blood component is also given to patients who have had excessive amounts of anticoagulation medications or who have undergone massive blood transfusions. Patients suffering from liver failure may also receive cryoprecipitate.
Freeze-dried factor concentrates are becoming the preferred type of plasma transfusion, when possible, due to the small amount required. This small amount makes the concentrates ideal for children, surgical patients, and patients who are receiving home care — anyone at risk of circulatory overload. Freeze-dried Factor VIII concentrate helps patients with hemophilia A and von Willibrands disease. Freeze-dried Factor IX-prothrombin complex, which contains coagulation Factors II, VII, IX, and X, treats patients with Factor IX deficiency, Factor VIII inhibitors, and liver disease. Doctors use concentrates with caution, however, as too much can lead to thrombosis.
Protein C, which stops the clotting process, is a type of plasma transfusion given to reduce thrombosis caused when protein C supplies become depleted. Depletion can occur in patients who have meningococcal septicemia resulting in DIC. Immunoglobulin-focused plasma transfusions provide the patient with an increased source of antibodies for protection against common viral and bacterial diseases. This type of treatment is given to patients with immune diseases and disorders, such as hypogammaglobulinemia and immune thrombocytopenia, and consists of specific antibodies. These specific antibodies may include anti-hepatitis B, anti-rubella, anti-herpes zoster, and anti-RhD factor.