Solvent Detergent FFP Classification
Solvent detergent Fresh Frozen Plasma (SD-FFP) is a blood product—specifically, it is a virally-inactivated plasma product derived from pooled donor plasma that has undergone pharmaceutical processing to reduce infectious disease transmission while maintaining hemostatic properties. 1
Blood Product vs. Blood Component Distinction
SD-FFP represents a pharmaceutical blood product rather than a simple blood component because:
It undergoes industrial viral inactivation processing using tri(n-butyl)phosphate (solvent) and Triton X-100 (detergent), followed by purification—this transforms it from a minimally processed component into a manufactured pharmaceutical product 2, 3
It is manufactured from pooled plasma (typically from multiple donors), standardized for coagulation factor content, and subjected to quality control measures that exceed those of standard single-donor FFP 3, 4
Regulatory agencies classify it as a pharmaceutical product with standardized characteristics, devoid of antibodies implicated in transfusion-related acute lung injury (TRALI), and with very high-level decontamination from transfusion-transmissible infectious agents 3
Clinical Context and Usage
SD-FFP is used in the UK for all patients born in 1996 or later to reduce the risk of variant Creutzfeldt-Jakob disease transmission, alongside methylene blue-treated plasma as alternative viral inactivation methods 1
The clinical indications for SD-FFP are identical to standard FFP:
- Replacement of coagulation factors during major hemorrhage (trauma, obstetrics) 1
- Acute disseminated intravascular coagulation with bleeding 1
- Active bleeding with INR >1.5 1
- Thrombotic thrombocytopenic purpura (preferably using pathogen-inactivated FFP) 1
Important Pharmaceutical Differences from Standard FFP
SD-FFP has reduced levels of certain coagulation factors compared to standard FFP:
- Factor V is reduced by approximately 31% 5
- Factor VIII is reduced by approximately 20-28% 5, 4
- Protein S is reduced by approximately 50% 5
- Fibrinogen content is relatively preserved 5
Despite these reductions, SD-FFP demonstrates equivalent clinical efficacy in correcting coagulopathy in liver disease and liver transplantation, with equal correction of clotting factors and partial thromboplastin time compared to standard FFP 4
Critical Clinical Caveat
The lower coagulation factor content may be clinically significant in specific populations:
- Patients with pre-existing Factor V deficiency 5
- Patients with congenital or acquired protein S deficiency 5
- Patients with severe liver disease requiring maximal factor replacement 5
The standard unit volume of SD-FFP (200 ml) is smaller than standard FFP (250-300 ml), which may further reduce the total dose of coagulation factors delivered per unit 5, 1