British Society of Haematology Guidelines on the spectrum of fresh frozen plasma and cryoprecipitate products: their handling and use in various patient groups in the absence of major bleeding

Green, Laura; Bolton‐Maggs, Paula; Beattie, C. P.; Cardigan, Rebecca; Kallis, Yiannis; Stanworth, Simon; Thachil, Jecko; Zahra, Sharon

doi:10.1111/bjh.15167

Cited by 121 publications

(112 citation statements)

References 55 publications

(69 reference statements)

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“…The evidence for laboratory thresholds for PLT and plasma transfusion is less established than RBC transfusion threshold evidence . However, many guidelines recommend avoiding plasma transfusions for common indications and the continued reduction in plasma collection and use might be a result of these recommendations . Additionally, vitamin K, prothrombin complex concentrates, and coagulation factor concentrates can be safer and/or more effective than plasma for their specific indications .…”

Section: Discussionmentioning

confidence: 99%

“…8,10,21 However, many guidelines recommend avoiding plasma transfusions for common indications and the continued reduction in plasma collection and use might be a result of these recommendations. 8,10,18,24,[30][31][32] Additionally, vitamin K, prothrombin complex concentrates, and coagulation factor concentrates can be safer and/or more effective than plasma for their specific indications. 18,32 In contrast, platelet collection slightly increased, while platelet transfusions slightly decreased from 2015 to 2017.…”

Section: Discussionmentioning

confidence: 99%

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Slowing decline in blood collection and transfusion in the United States – 2017

et al. 2020

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INTRODUCTION The National Blood Collection and Utilization Survey (NBCUS) has demonstrated declines in blood collection and transfusion in the United States since 2008, including declines of 11.6% in red blood cell (RBC) collections and 13.9% in RBC transfusions during 2013‐2015. This study described the 2017 NBCUS results. METHODS The 2017 NBCUS was distributed to all US blood collection centers, all hospitals performing at least 1000 surgeries annually, and a 40% random sample of hospitals performing 100 to 999 surgeries annually. Weighting and imputation were used to generate national estimates for units of blood and components collected, deferred, distributed, transfused, and outdated. RESULTS Response rates for the 2017 NBCUS were 88% for blood collection centers and 86% for transfusing hospitals. Compared with 2015, the number of RBC units collected during 2017 (12,211,000; 95% confidence interval [CI], 11,680,000‐12,742,000) declined by 3.0%, and transfused RBC units (10,654,000, 95% CI, 10,314,000‐10,995,000) declined by 6.1%. Distributed platelet (PLT) units (2,560,000; 95% CI, 2,391,000‐2,730,000 units) increased by 5.1%, and transfused PLT units (1,937,000, 95% CI, 1,794,000‐2,079,000) declined by 2.3%. Distributed plasma units (3,209,000; 95% CI, 2,879,000‐3,539,000) declined by 13.6%, and transfused plasma units (2,374,000; 95% CI, 2,262,000‐2,487,000) declined by 12.9%. CONCLUSION The 2017 NBCUS suggests a continued but slowing decline in demand for RBCs. The decline in blood collection and use will likely continue. Despite decreasing demand and increasing manufacturing costs of blood products, the US blood industry has met the regular and emergent needs of the country.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Slowing decline in blood collection and transfusion in the United States – 2017

et al. 2020

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“…Additionally, these guidelines further recommend against FFP transfusion in the preprocedure setting because of a lack of efficacy and the potential to increase venous pressure and thereby procedural bleeding risk. [4][5][6] A recent study measuring thrombin generation pre-/post-FFP in patients with CLD with bleeding or the periprocedural setting further confirmed the lack of hemostatic effect with a minimal increase (5.7%) in thrombin-generating capacity following FFP. Of note, 96% of the cohort demonstrated thrombin generation profile within normal limits before FFP transfusion.…”

Section: Comment On Comparison Of Three Transfusion Protocols Prior Tmentioning

confidence: 89%

Comment on Comparison of three transfusion protocols prior to central venous catheterisation in patients with cirrhosis; a randomised controlled trial

Roberts

Arya

Hogan

2020

Journal of Thrombosis and Haemostasis

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“…Previous publications have assessed other formulations of pathogen‐reduced cryoprecipitate. In general, two different manufacturing processes to reduce pathogen activity in plasma are available: solvent/detergent treatment or the addition of a photosensitizer that inactivates DNA and RNA upon ultraviolet or long wavelength visible light exposure …”

Section: Discussionmentioning

confidence: 99%

“…In general, two different manufacturing processes to reduce pathogen activity in plasma are available: solvent/detergent treatment or the addition of a photosensitizer that inactivates DNA and RNA upon ultraviolet or long wavelength visible light exposure. 28 The intrinsic effects of pathogen inactivation on fibrinogen structure or function are poorly understood. Backholer and colleagues 15 published one of the first studies directly comparing the cryoprecipitate made from amotosalen-treated plasma and cryoprecipitate made from methylene blue-treated plasma to cryoprecipitate made from untreated plasma.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of a new pathogen‐reduced cryoprecipitate stored 5 days after thawing to correct dilutional coagulopathy in vitro

et al. 2019

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BACKGROUND Fibrinogen supplementation during bleeding restores clot strength and hemostasis. Cryoprecipitate, a concentrated source of fibrinogen, has prolonged preparation time for thawing, a short shelf life resulting in frequent wastage, and infectious disease risk. This in vitro study investigated the efficacy of a new pathogen‐reduced cryoprecipitate thawed and stored at room temperature for 5 days (PR Cryo) to treat dilutional hypofibrinogenemia, compared to immediately thawed standard cryoprecipitate (Cryo) or fibrinogen concentrate (FC). STUDY DESIGN AND METHODS Ten phlebotomy specimens from healthy volunteers were diluted 1:1 with crystalloid and supplemented with PR Cryo and Cryo (at a dose replicating transfusion of two pooled doses [10 units]) and FC at a dose replicating 50 mg/kg. Changes in clot firmness (thromboelastometry) and in coagulation factor activity were assessed at baseline, after dilution, and after supplementation. RESULTS Clinical dosing was used, as described above, and consequently the FC dose contained 24% and 36% more fibrinogen versus PR Cryo and Cryo, respectively. At baseline, subjects had a median FIBTEM maximum clot firmness of 13.5 mm, versus 6.5 mm after 50% dilution (p = 0.005). After supplementation with PR Cryo, a median FIBTEM maximum clot firmness of 13 mm was observed versus 9.0 mm for Cryo (p = 0.005) or 16.5 mm for FC (p = 0.005). Median factor XIII was higher after PR Cryo (64.8%) versus Cryo (48.3%) (p = 0.005). Fibrinogen activity was higher after FC (269.0 mg/dL) versus PR Cryo (187.0 mg/dL; p = 0.005) or Cryo (193.5 mg/dL; p = 0.005); the difference between PR Cryo and Cryo supplementation (p = 0.445) was not significant. CONCLUSION PR Cryo used 5 days after thawing effectively restores clot strength after in vitro dilution.

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British Society of Haematology Guidelines on the spectrum of fresh frozen plasma and cryoprecipitate products: their handling and use in various patient groups in the absence of major bleeding

Cited by 121 publications

References 55 publications

Slowing decline in blood collection and transfusion in the United States – 2017

Slowing decline in blood collection and transfusion in the United States – 2017

Comment on Comparison of three transfusion protocols prior to central venous catheterisation in patients with cirrhosis; a randomised controlled trial

Efficacy of a new pathogen‐reduced cryoprecipitate stored 5 days after thawing to correct dilutional coagulopathy in vitro

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