Indications and side effects of plasma and plasma products

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Indications and side effects of plasma and plasma products

Transcript Of Indications and side effects of plasma and plasma products

16th International Haemovigilance Seminar Barcelona, March 5-7, 2014
Plasma transfusions are indicated in the following cases:
Indications and side effects of plasma and plasma products
Source: Liumbruno, G., Bennardello, F., Lattanzio, A., Piccoli, P., & Rossetti, G. (2009). Recommendations for the transfusion of plasma and platelets. Blood Transfusion, 7(2), 132–50. M. Schipperus, MD/PhD Chairman of the board, TRIP (Transfusion Reactions In Patients), The Hague, the Netherlands

16th International Haemovigilance Seminar Barcelona, March 5-7, 2014

Indications and side effects of plasma and plasma products
Actual use of plasma:

Procedure/clinical indication
Surgery Warfarin reversal Other coagulopathy Before invasive procedure Bleed Massive transfusion Plasma exchange Trauma Miscellaneous

Percentage of FFP transfusions 33.3% 20.2% 14.3% 5.9%
8.4% 7.3% 3.8% 0.3% 6.3%

>50% acute situations

Source: Tinmouth, A. et al (2013). Utilization of frozen plasma in Ontario: a province wide audit reveals a high rate of inappropriate transfusions. Transfusion, 53(10), 2222–9.
M. Schipperus, MD/PhD

16th International Haemovigilance Seminar Barcelona, March 5-7, 2014
Indications and side effects of plasma and plasma products
Actual use of plasma:
55% of plasma transfusions could be qualified as appropriate based on internationally agreed-upon indications, with fully 28% qualifying as inappropriate and the remainder as indeterminate
Source: Tinmouth, A. et al (2013). Utilization of frozen plasma in Ontario: a province wide audit reveals a high rate of inappropriate transfusions. Transfusion, 53(10), 2222–9.
M. Schipperus, MD/PhD

16th International Haemovigilance Seminar Barcelona, March 5-7, 2014
Indications and side effects of plasma and plasma products
Available types of plasma: Quarantined Fresh Frozen Plasma (Q-FFP) • Apheresis plasma (from one donor) stored in quarantine for six months • Donor tested for certain diseases during donation; retested 6 months later (window period) • Plasma released for use if donor clears second round of testing & given to patient • Expiry: 3-36 months after donation (depending on storage temperature)

Blood tests: HIV, HBV, HCV, Syphilis, HTLV-I/II

6 months

Blood tests: HIV, HBV, HCV, Syphilis, HTLV-I/II

M. Schipperus, MD/PhD

16th International Haemovigilance Seminar Barcelona, March 5-7, 2014
Indications and side effects of plasma and plasma products
Pathogen reduction methods:
M. Schipperus, MD/PhD

16th International Haemovigilance Seminar Barcelona, March 5-7, 2014
Indications and side effects of plasma and plasma products
Available types of plasma: INTERCEPT Plasma (Amotosalen Inactivated) • Apheresis plasma (from one donor) • Units processed using INTERCEPT pathogen reduction system in-house • Can be used with either freshly collected or frozen plasma which has been recently thawed
Blood tests: HIV, HBV, HCV, Syphilis, HTLV-I/II
M. Schipperus, MD/PhD

16th International Haemovigilance Seminar Barcelona, March 5-7, 2014
Indications and side effects of plasma and plasma products
Available types of plasma: Mirasol® Plasma (Riboflavin + UV Inactivated) • Apheresis plasma (from one donor) • Units processed using Mirasol pathogen reduction system in-house • Can be used with either freshly collected or frozen plasma which has been recently thawed
Blood tests: HIV, HBV, HCV, Syphilis, HTLV-I/II
M. Schipperus, MD/PhD

16th International Haemovigilance Seminar Barcelona, March 5-7, 2014
Indications and side effects of plasma and plasma products
Available types of plasma: THERAFLEX Plasma (Methylene Blue Inactivated) • Apheresis plasma (from one donor) or whole blood • Units processed using THERAFLEX pathogen reduction system in-house • Can be used with either freshly collected or frozen plasma which has been recently thawed
Blood tests: HIV, HBV, HCV, Syphilis, HTLV-I/II
M. Schipperus, MD/PhD

16th International Haemovigilance Seminar Barcelona, March 5-7, 2014

Indications and side effects of plasma and plasma products

Available types of plasma:

Solvent/Detergent treated pooled Plasma (SDP) – e.g. Octaplas™, Omniplasma™ (TNBP + Triton X-100)

• Plasma from ~1000 donors pooled

• Pool undergoes pathogen inactivation process

( )x • Plasma separated into individual bags of uniform composition Blood tests: HIV, HBV, HCV, Syphilis, HTLV-I/II

1000

M. Schipperus, MD/PhD

Blood tests: HAV, Parvo*
(non-enveloped)

Pooling/ Pathogen Reduction
*Test is done to confirm presence of antibodies against these viruses.

16th International Haemovigilance Seminar Barcelona, March 5-7, 2014
Indications and side effects of plasma and plasma products
Effect of filtration:
M. Schipperus, MD/PhD
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