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 (<i>Br J Haematol</i>. 2018;181:54–67). Addendum August 2020

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

doi:10.1111/bjh.17104

Cited by 3 publications

(11 citation statements)

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“…Plasma is transfused for a relatively short list of indications in a variety of clinical situations, ranging from exchange transfusion in thrombotic thrombocytopaenia purpura to address acquired or inherited ADAMTS‐13 deficiency, to treatment of trauma with or without activation of massive transfusion protocols (MTP) [2, 20–23]. The typical aim of plasma transfusion is therefore to restore or augment coagulation.…”

Section: Discussionmentioning

confidence: 99%

“…In the absence of such evidence, transfusion services have sought to minimize losses of procoagulant activity in transfusable plasma, while maintaining operational flexibility. Plasma is transfused in North America following refrigerated storage for up to 5 days for any indication [4, 29] and, in the United Kingdom, only for patients suffering major unexpected haemorrhage [2], despite the loss of up to half of its initial FVIII activity. Recently, additional support for this approach has emerged in a secondary analysis of data from a randomized clinical trial of pre‐hospital plasma transfusion, showing that plasma thawed and refrigerated for either 0–2 days or 2–5 days showed equivalent clinical benefit [30].…”

Section: Discussionmentioning

confidence: 99%

“…Thawing prior to transfusion is performed in watertight plastic overwraps under gentle agitation in a water bath set at 30–37°C in Canada, while in the United Kingdom, most hospitals use plasma thawers. Thawed plasma can be stored for a maximum of 120 h (5 days) at 1–6°C in both Canada and the United Kingdom [1, 2].…”

Section: Introductionmentioning

confidence: 99%

“…Little published information is available regarding the potential increased risk of septic transfusion reactions with thawed plasma. As stated by Cardigan and Green [2], the risk of a septic transfusion reaction due to bacterially contaminated plasma is very low mainly because the storage conditions of thawed plasma (1–6°C) limit bacterial growth and the units remain closed after thawing. In 2016, the Food and Drug Administration (FDA) documented a possible fatal septic transfusion case involving a plasma unit contaminated with coagulase‐negative Staphylococcus [6].…”

Section: Introductionmentioning

confidence: 99%

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Challenging the 30‐min rule for thawed plasma

et al. 2021

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Background and Objectives Frozen plasma (FP) is thawed prior to transfusion and stored for ≤5 days at 1–6°C. The effect of temperature excursions on the quality and safety of thawed plasma during 5‐day storage was determined. Materials and Methods Four plasma units were pooled, split and stored at ≤−18°C for ≤90 days. Test units T30 and T60 were exposed to 20–24°C (room temperature [RT]) for 30 or 60 min, respectively, on days 0 and 2 of storage. Negative and positive control units remained refrigerated or at RT for 5 days, respectively. On Day 5, test units were exposed once to RT for 5 h. Quality assays included stability of coagulation factors FV, FVII, FVIII, fibrinogen and prothrombin time. Bacterial growth was performed in units inoculated with ~1 CFU/ml or ~100 CFU/ml of Serratia liquefaciens, Pseudomonas putida, Pseudomonas aeruginosa or Staphylococcus epidermidis on Day 0. Results Testing results of all quality parameters were comparable between T30 and T60 units (p < 0.05). Serratia liquefaciens proliferated in cold‐stored plasma, while P. putida showed variable viability. Serratia epidermidis and P. aeruginosa survived but did not grow in cold‐stored plasma. Positive and negative controls showed expected results. Overall, no statistical differences in bacterial concentration between T30 and T60 units were observed (p < 0.05). Conclusion Multiple RT exposures for 30 or 60 min do not affect the stability of coagulation factors or promote bacterial growth in thawed plasma stored for 5 days. It is therefore safe to expose thawed plasma to uncontrolled temperatures for limited periods of 60 min.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Challenging the 30‐min rule for thawed plasma

et al. 2021

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“…Numerous studies have demonstrated no significant benefit from using prophylactic FFP or cryoprecipitate prior to procedures in non-bleeding patients with abnormal clotting tests [54][55][56][57] with evidence that FFP transfusion in practice usually fails to correct abnormal PT ratio/INR values. 58 In a separate BSH guideline, 59 it is noted that the impact of commonly used doses of FFP to correct clotting results, or to reduce the bleeding risk, is very limited particularly when the PT ratio/INR is between 1.5 and 1.9.…”

Section: Fresh Frozen Plasmamentioning

confidence: 99%

A British Society for Haematology guideline on the assessment and management of bleeding risk prior to invasive procedures

Lester,

Bent,

Alikhan

et al. 2024

Br J Haematol

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This guideline was compiled according to the British Society for Haematology (BSH) process at https:// b-s-h. org. uk/ . The Grading of Recommendations Assessment, Development and Evaluation (GRADE) nomenclature was used to evaluate the levels of evidence and to assess the strength of recommendations. The GRADE criteria can be found at http:// www. grade worki nggro up. org. A literature search was carried out using the terms given in Appendix.

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Transfusion of blood components in pediatric age groups: an evidence-based clinical practice guideline adapted for the use in Egypt using ‘Adapted ADAPTE’

Mokhtar,

Adly,

Baky

et al. 2024

Ann Hematol

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Pediatric transfusion is a complex area of medicine covering a wide age range, from neonates to young adults. Compared to adult practice, there is a relative lack of high-quality research to inform evidence-based guidelines. We aimed to adapt the pre-existing high-quality practice guidelines for the transfusion of blood components in different pediatric age groups to be available for national use by general practitioners, pediatricians, and other health care professionals. The guideline panel included 17 key leaders from different Egyptian institutions. The panel used the Adapted ADAPTE methodology. The panel prioritized the health questions and recommendations according to their importance for clinicians and patients. The procedure included searching for existing guidelines, quality appraisal, and adaptation of the recommendations to the target context of use. The guideline covered all important aspects of the indications, dosing, and administration of packed red cells, platelets, and fresh frozen plasma. It also included transfusion in special situations, e.g., chronic hemolytic anemia and aplastic anemia, management of massive blood loss, malignancies, surgery, recommendations for safe transfusion practices, and recommendations for modifications of cellular blood components. The final version of the adapted clinical practice guideline (CPG) has been made after a thorough review by an external review panel and was guided by their official recommendations and modifications. A set of implementation tools included algorithms, tables, and flow charts to aid decision-making in practice. This adapted guideline serves as a tool for safe transfusion practices in different pediatric age groups.

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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 (Br J Haematol. 2018;181:54–67). Addendum August 2020

Cited by 3 publications

References 2 publications

Challenging the 30‐min rule for thawed plasma

Challenging the 30‐min rule for thawed plasma

A British Society for Haematology guideline on the assessment and management of bleeding risk prior to invasive procedures

Transfusion of blood components in pediatric age groups: an evidence-based clinical practice guideline adapted for the use in Egypt using ‘Adapted ADAPTE’

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