Evaluation of fresh frozen plasma usage at a tertiary care hospital in North India

Background: Concerns regarding transfusion-transmitted infections and non-availability of blood components in developing nations, make it crucial to optimize fresh frozen plasma (FFP) transfusions and reduce wastage. Methods: A concurrent prospective study of FFP usage was carried out in a tertiary care hospital in north India. Results: A total of 595 units were issued to 112 patients during the study period, of which 53 units (8.9%) were returned to the blood centre unused, leading to wastage. Appropriate indications for FFP usage were as per accepted British Council for Standardization in Haematology (BCSH) criteria. Among 112 patients 33 (29.5%) had had appropriate FFP transfusions ( 205 units) for indications that primarily included chronic liver disease, disseminated intravascular coagulopathy and prolonged bleeding with abnormal coagulation profile. Out of 33 patients with appropriate indications, 24 had abnormal coagulation profile but only half of these patients (n = 12) received adequate dose of FFP. Fresh frozen plasma was used for inappropriate indications in 79 patients (70.5%), which mainly included bleeding following cardiac surgery with normal coagulation test results, hypovolaemia and hypoproteinaemia. Such misuse was higher in surgical units than medical services ( 78 vs 45%). Conclusion: Fresh frozen plasma is grossly misused even in resource-deficient nations and immediate intervention is needed to stem the flow of this component. Physician education programmes and a monitoring system to ensure strict adherence to the established guidelines are required to reduce undue waste of this blood component.