Plasma is the acellular component of blood.
It contains clotting factors, proteins, Igs, cytokines…
Types of plasma for transfusion:
1* FFP: frozen with 8 hrs of collection, contains all clotting factors.
2FP: frozen within 24 hrs of collection, contains less factor viii than FFP.
3Pooled plasma: collected from multiple donors to increase the amount of clotting factors; carries higher risk of infection transmission.
4*Cryopercipitate.
In a large study it was found that 1/3 of plasma transfusions in PICU was not indicated.
Most patients with mild to moderate coagulopathy (i.e mild to moderate elevation of PT, aPTT)without bleeding were not senstive to plasma transfusion (i.e plasma did not improve coagulopathy).
In a large study it was found that 1/3 of plasma transfusions in PICU was not indicated.
As a bioactive subatance; plasma transfusion can cause many side effects 
e.g. infections, TRALI, Allergic reactions & overload…
Excessive plasma transfusion can cause citrate toxicity​:arrow_right: hypoCa, hypoMg…
e.g. infections, TRALI, Allergic reactions & overload…
Dose of plasma transfusion:
10-15ml/kg.
Plasma transfusion should be from ABO compatible donor, AB blood group is a universal donor for plasma.
Plasma transfusion needs no compatibility testing or cross matching.
Rh grouping is not needed for plasma transfusion.
When to transfuse plasma​:question:
1* Patients who received massive PRBCs transfusion (i.e 40-80ml/kg within 24 hrs).
2* Bleeding patients:
- massive or critical bleeding.
- Non massive bleeding only if:
•INR > 2.
•PT or aPTT ratio > 1.5
N.B Plasma transfusion doesn’t correct mild-moderate coagulopathy.
3* DIC.
4* Liver disease: if there is severe bleeding with abnormal coagulation testing.
5* Single clotting factor deficiency if the isolated factor is not available.
6* Warfarin toxicity.
7* Distressing Hereditary angioedema if C1 Esterase inhibitor is not available.
Prophylactic plasma transfusion is recommended only befor surgery or invasive procedures if there is abnormal coagulation testing otherwise it is not recommended nor supported by evidence.