Plasma vs FFP: Understanding the Terminology
"Plasma" and "Fresh Frozen Plasma (FFP)" are essentially the same product in clinical practice—FFP is simply the specific technical term for plasma that has been rapidly frozen to -25°C or below to preserve labile coagulation factors. 1
Key Distinctions
What FFP Actually Is
- FFP is plasma that has been frozen within a specific timeframe and temperature to preserve all soluble coagulation factors, particularly the labile factors V and VIII 1
- The rapid freezing to below -25°C is what distinguishes FFP from other plasma products and maintains the integrity of temperature-sensitive clotting factors 1
- When clinicians order "plasma" in most hospital settings, they are ordering FFP unless otherwise specified 2
Storage and Handling Differences
- FFP must remain frozen at -25°C or below until use 1
- Once thawed, FFP can be stored at 4°C for up to 24 hours (or 5 days specifically for major trauma hemorrhage) 1
- After removal from refrigeration, FFP must be used within 30 minutes 1
- Never refreeze thawed FFP 1
Other Plasma Products That May Exist
- Modern blood banks may stock several different plasma preparations beyond standard FFP, which should all be equally efficacious for reversing significant coagulopathy 2
- The specific naming (FFP vs "plasma") may vary by institution, but the functional product for clinical use is typically the same
Clinical Indications (Regardless of Terminology)
When to Transfuse
- Active bleeding with documented coagulopathy: PT >1.5 times normal, INR >2.0, or aPTT >2 times normal 3, 4
- Urgent warfarin reversal when prothrombin complex concentrates are unavailable 3, 4
- Major hemorrhage requiring multiple coagulation factor replacement, particularly in trauma and obstetrics 3, 4
Dosing
- Standard therapeutic dose: 15 ml/kg to achieve minimum 30% concentration of plasma factors 1, 3
- For warfarin reversal: 5-8 ml/kg is typically sufficient 3
- Approximate volume per bag: 300 mL 1