Plasma:

• is prepared from whole blood collected in a closed system into CP2D or CPD; or

• is collected through apheresis in a closed system into ACD-A.

Plasma is frozen at a temperature less than or equal to −18°C within 24 hours after collection. This product contains proteins such as albumin and coagulation factors.

Action

Plasma is administered to recipients to correct a qualitative or quantitative deficiency in coagulation factors.

Main indications

A number of coagulation factor concentrates are commercially available and should be used preferentially over plasma due to their fast action and their lower risk of infection or volume overload.

Frozen plasma is indicated under the following conditions:

• mass transfusions;
• patient with hemorrhaging or who must undergo surgery if coagulation factor concentrates or other treatments are not available (e.g., during liver failure);
• diffuse microvascular bleeding (e.g., during disseminated intravascular coagulation (DIC));
• thrombotic thrombocytopenic purpura.

Contraindications

Plasma is not indicated for replacing coagulation factor deficiencies when a specific stable product is available. Also, if time permits, thawed plasma must not be used when the coagulopathy can be more effectively rectified using a specific treatment such as administering vitamin K. In the event of urgent warfarin reversal, preference must be given to using prothrombin complex concentrates.

Dosage and administration

The volume transfused depends on the recipient’s clinical presentation and weight; it can be determined based on the results of laboratory tests assessing the clotting.

The product is thawed in a double boiler or other device certified for this purpose. When thawing in the double boiler, the transfusion fittings must be protected from contact with the water by placing the plasma bags into an airtight plastic protective sleeve. It’s best to limit the number of plasma bags to be thawed at the same time in order not to unduly alter the temperature of the double boiler and have to extend the thawing time.

The product must not be used if the container is damaged or if the product was thawed during storage.

Storage

Plasma can be stored for 12 months at a temperature less than or equal to −18°C. Once thawed, plasma can be stored:

• at a temperature of 1°C to 6°C for a maximum of 5 days before transfusion; or
• 24 hours if the circuit has been opened;

It must not be refrozen.

In the event of a discrepancy between the information on this page and what is in the Circular of information, the latter will take precedence.