Analysis of Appropriateness and Efficacy of Fresh Frozen Plasma Transfusion

Background : This study was performed to analyze the appropriateness and the efficacy of fresh frozen plasma (FFP) transfusions for the treatment of coagulopathy. Methods : Three hundred and eleven patients with FFP transfusion histories were evaluated on the state of coagulopathy and the reasons for transfusion. The reasons were classified according to the recommendations by the British Committee for Standards in Haematology (BCSH) for evaluation of transfusion appropriateness. The efficacy of transfusions was evaluated in 144 patients with coagulopathy by means of PT(%) and aPTT(sec). Corrected PT(cPT) and corrected aPTT (caPTT) were defined as PT and aPTT divided by the transfusion amount, and these were compared among the disease groups. Results : Forty-two patients (30.5%) were definitely indicated, and 53 patients (17.0%) were conditionally indicated. One hundred and eighty-four patients (59.2%) were transfused with no justification for the transfusions. Of the improved cases, 27.8% of the patients scored at more than 10% in the PT(%) category. In 28.1% of the patients, there were more than 10 sec in aPTT(sec). There was a significant correlation between the volume of the transfusion (mL/kg) and the PT and aPTT(r=0.2932, P=0.0004; r=0.2379, P=0.0047; respectively). The cPT had an inverse correlation to the elapsed time from transfusion to the coagulation assay(r=-0.1815, P=0.0301). The cPT and the caPTT were significantly lower in patients with liver disease than those with DIC (P=0.0009, P=0.0084; respectively). Conclusions : We found that FFP was transfused more inappropriately than should have been. The transfusion volume was the most significant factor for the efficacy of FFP transfusions. FFP transfusions were less efficient in the patients with liver disease.