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Blood Products - Blood Components (Other)

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Fresh Frozen Plasma

Indications for use of FFP are:

  • DIC (in conjunction with cryoprecipitate)
  • massive transfusion requirements
  • severe liver disease.

Always check a full coagulation profile, FDP or D-dimers.

Dose: FFP comes in packs of 50 and ~200 - 250 mls. Record volume infused for fluid balance.

  • 10 - 15 mls/kg initially in DIC. Check clotting screen frequently and adjust further FFP doses in discussion with a haematologist/transfusion medicine specialist.
  • After 1.5 x blood volume loss there will be coagulation factor deficiency and requirement for FFP. As this takes 30 minutes to defrost, request 10-15 ml/kg after RBC replacement of 1 x blood volume (approx 70 ml/kg but varies with age). Repeat clotting screen after initial dose to assess the need for further treatment. Platelets may also be required so check platelet count.
  • ABO compatible units should be given if possible. If these are not available, seek advice from the on call transfusion medicine specialist at NZBS .
  • Use as soon as it is thawed.
  • No need for irradiation.
  • Rh (D) negative children can receive Rh (D) positive FFP without the need for anti-D due to the negligible risk of alloimmunisation with plasma components.

Cryoprecipitate

  • Rich in fibrinogen and factor VIII.
  • Dose is 5-10 mls/kg in DIC. Check clotting frequently.
  • Small volume, 25 mls of fluid in each pack so useful for DIC with fluid overload and hypofibrinogenaemia. Always check clotting screen.
  • 1 unit has around 125 units of factor VIII.
  • No need for ABO matching or irradiation.
  • Use as soon as it is thawed.
  • Rh (D) negative children can receive Rh (D) positive cryoprecipitate.

Acquired deficiency of von Willebrand's Factor

Wilm's tumours are occasionally complicated by an acquired deficiency of von Willebrand's factor. This is rarely of clinical significance but should be corrected with CSL factor VIII (Biostate)(not recombinant factor VIII) 15 units/kg if patient is due to undergo major surgery.

References

  1. NZBS transfusion medicine handbook 2008

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Document Control

  • Date last published: 20 April 2016
  • Document type: Clinical Guideline
  • Services responsible: National Child Cancer Network
  • Owner: Siobhan Cross
  • Review frequency: 2 years