Fresh Frozen Plasma Transfusion Practices and Coagulation Response in Real-World Clinical Settings: Focus on Indications and Dosing
10.17945/kjbt.2025.36.3.143
- Author:
Hee Sue PARK
;
Kiwook JUNG
;
Bo Ra SON
- Publication Type:Original Article
- From:Korean Journal of Blood Transfusion
2025;36(3):143-154
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:Fresh frozen plasma (FFP) is widely used to correct coagulopathy. However, many transfusions are administered without adherence to guidelines. The clinical utility of pre-transfusion coagulation tests and optimal dosing strategies remains poorly defined in practice.
Methods:We retrospectively reviewed 181 adult patients who received FFP transfusions at a tertiary hospital from January to December 2023. Indications were selected by clinicians from a predefined checklist. Changes in prothrombin time-international normalized ratio (PT-INR), activated partial thromboplastin time (aPTT), and fibrinogen were analyzed. Multivariate linear regression was used to predict PT-INR correction. Time to post-transfusion testing was also evaluated.
Results:Among 518 episodes, 39.6% of transfusions were administered to patients with a PT-INR＜1.7, indicating that the guideline criteria were not met. The median volume was 7.0 mL/kg, with only 16.2% exceeding 10 mL/kg.Pre-transfusion PT-INR was the strongest predictor of correction (β=–1.003, P＜0.001). Greater volumes of transfused FFP led to better correction, especially in individuals with PT-INR ≥3.0. The median time to follow-up testing was 8.5 hours, but showed no significant effect on correction.
Conclusion:FFP transfusion was most effective in patients with severe PT-INR prolongation. Frequent inappropriate transfusions and subtherapeutic dosing limited its effectiveness. These findings highlight the importance of targeted education and implementation of INR-based indications to improve FFP transfusion practices.
