Blood Components Replacement

Blood products and modifiers.

Dried Prothrombin Complex

Factor VIII fraction

Fresh Frozen Plasma

• Plasma, including all coagulation factors and plasma proteins

• All cellular components are removed from the transfusion product.

• Unit volume: ∼200–300 mL

• ABO compatibility must be considered.

• Rh(D) matching: not required

• Management of coagulopathy in patients with multiple clotting factor deficiencies (e.g., due to liver cirrhosis, DIC)

• Prevention of dilutional coagulopathy in massive transfusion

• Plasma exchange transfusion, e.g., in TTP [44]

• Management of some coagulation factor deficiencies if no specific concentrate for treatment exists

• Alternative therapy for:

  • Management of plasma protein deficiencies if recombinant products are unavailable

  • Immediate reversal of warfarin in patients with life-threatening bleeding or intracranial hemorrhage if 4-factor PCC is unavailable

• Correction of both isolated and multiple coagulation factor deficiencies

• Intravascular volume expansion roughly equivalent to unit volume

• Vitamin K-dependent clotting factors: factors II, VII, IX, and X [

• Anticoagulants: protein C, protein S, antithrombin, and/or heparin

• Vitamin K antagonist-associated major bleeding: 4-factor PCC is given with IV vitamin K

• Treatment and prevention of bleeding in patients with rare clotting factor deficiencies if specific factor preparations are not available

• Consider for the reversal of DOACs in life-threatening bleeding

• Thrombotic complications (e.g., VTE, myocardial infarction)

• HIT

• Hypersensitivity reactions (e.g., anaphylaxis)