Compare and contrast fresh frozen plasma and prothrombin complex concentrate.
Very few answers included details on prothrombin complex concentrate which meant it was difficult to score well. Useful headings included preparation and administration, dose, indications and adverse effects. Not many candidates knew the dose of FFP, and few were able to describe the preparation/production of the product. Few candidates knew the factors available from either product. Commonly missed was the need for ABO typing for FFP and that Prothrombin complex concentrate did not require this
| Fresh frozen plasma | Prothrombinex | |
| Description | The liquid portion of the blood, separated and frozen within 8 hours of collection | Lyophilised human clotting factor concentrate |
| Presentation | 250-300ml bags, clearly labelled with the donor blood type. | Glass vial with powdered concentrate inside, for reconstitution with sterile water. Each vial usually contains 500 units. |
| Preparation | Separation (by centrifuge) from whole blood, either after donation or by apheresis. It must be prepared and frozen within 6-18 hours. | Prepared by adsorption of coagulation factors from plasma onto an ion exchange medium followed by selective elution |
| Contents |
Essentially all clotting factors except fibrinogen
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| Storage |
can be stored frozen for up to 12 months at -25ºC. |
Refrigerated, stored for 6 months |
| Indications |
Coagulopathy Plasma exchange ACE-I angioedema C1 esterase inhibitor deficiency Suxamethonium apnoea |
Warfarin reversal Correction of coagulopathy from deficiency of specific factors |
| Dose | 10–15 mL/kg per dose | For the reversal of warfarin is 15–50 IU/kg |
| Precautions | Large volume: may cause circulatory overload | Small volume: not a resuscitation fluid |
| Group, crossmatch | Needs to be ABO grouped, but does not require crossmatch | Does not need to be ABO grouped or crossmatched |
| Adverse effects |
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Benjamin, Richard John, and Lisa Swinton McLaughlin. "Plasma components: properties, differences, and uses." Transfusion 52 (2012): 9S-19S.
Khawar, Hina, et al. "Fresh frozen plasma (FFP)." StatPearls [Internet] (2020).
Anderson, Brian J., Steven R. Keeley, and Neil D. Johnson. "Prothrombinex‐induced thrombosis and its management with regional plasminogen activator in hepatic failure." Medical journal of Australia 153.6 (1990): 352-356.