An audit on usage of fresh frozen plasma in a tertiary care hospital in north western part of India

Anshika Yadav, Priyanka Tiwari, Akhil K. Sheemar


Background: Every blood Component carries inherent risk of adverse transfusion reactions and transmission of transfusion transmitted disease (TTD). The adverse transfusion reactions are unpredictable and makes transfusion services puzzled, FFP being the most common one, it is therefore necessary that appropriate and rational use of FFP is done to make transfusion safer in terms of patient safety. The objective of the study was to assess the utilisation of FFP in a tertiary care Hospital.

Methods: We conducted a retrospective study on 256 patient who received FFP transfusion at our tertiary care hospital over a period of 6 months .The usage was classified as appropriate or inappropriate based on the guidelines for FFP usage by British committee for standards in haematology, 2004 and college of American pathologist, 1994.

Results: There were 256 patients in the study period who received 1370 units of FFP transfusions. The male: Female ratio was 162 M & 94 F. Most of the patients belonged to Gastroenterology Department (41.75%) followed by CTVS (15.32%). 29.48% of FFP transfusions were reclassified as inappropriate either due to Lack of indication or inappropriate doses.

Conclusions: The study emphasize on the need to incurate rational use of blood components which is FFP in present case for evolving safe transfusion practices in the country. This study highlights no adherence to guidelines among clinicians which is mainly due to lack of knowledge of appropriate usage.


Audit, Fresh frozen plasma, Transfusion

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British Committee for standards in Hematology Guidelines for the use of fresh frozen plasma. Transfusion Med. 2:57-63.

Serious Hazards of Transfusion Annual report; Available from:

College of American pathologists Practice Guidelines Development Task Force, Practice parameters for the usage of FFP, cryo and platelets, JAMA. 1994;271;777-81.

Moiz B, Arif FM, Hashmi KZ. Appropriate and inappropriate use of fresh frozen plasma, J. Pakistan Med Assoc. 2006;506(8):356-9.

Chng WJ, Tan MK, Kuperan P An audit of fresh frozen plasma usage in an acute general hospital is Singapore, Singapore Med J. 2003;44(11):574-8.

Sinagare SA, Angarkar NN, Desai SR, Naniwadekar NR. An Audit of fresh frozen plasma usage and effect of fresh frozen plasma on the pre transfusion international normalized ratio Asian J Tranf Sci. 2010;4(2):128-32.

Mozes B, Epstein M, Ben-Bassat I. Modan B, Halkin H. Evaluation of the appropriateness of blood and blood product transfusion using preset criteria. Transfusion. 1989;29(6):473-6.

Luk C, Eckert KM, Barr RM, Chinyee I. Prospective audit of the use of fresh-frozen plasma, based on Canadian Medical Association transfusion guidelines CMAJ. 2002;166:1539-40.

Tuckfield A, Haeusler MN, Grigg AP, Metz J. Reduction o inappropriate use of blood products by prospective monitorin of transfusion request forms. Med J Aust. 1997;167:473-6.

Prathiba R, Jayaranee S, Ramesh JC, Lopez CG, Vasanthi N, An audit of fresh frozen plasma usage in a tertiary referra centre in a development country. Malaysian J Pathol. 2001;2:41-6.

Kakkar N, Kaur R, Dhanoa J. Improvement in fresh froze plasma transfusion practice results of an outcome audit Transfus Med. 2004;14:231-5.

Liumbruno GM, Sodini ML, Grazzini G. Tuscan study on the appropriateness of Fresh-frozen plasma Transfusion. Blood Transfus. 2007;5(2):59-61.

Pervaiz A, Naseem L, The trends of use of fresh frozen plasma a tertiary care hospital int J Pathol. 2009;7(2):88-93.

Hui Ch, Willianms I, Davis K, Clinical audit of fresh frozen plasma and platelest in a tertiary teaching hospital and the impact of a new transfusion request form. Intern Med J, 2005;35(5):283-8.

Levi M, ten Cate H. Disseminated intervascular coagulation engl. J Med. 1999;341:586-92.

Kulkarni N. Evaluation of fresh frozen plasma usage at a medical college hospital – A two year study. Int J Blood Transfus Immunohematol. 2012;2:56-9.

Chaudhary R, Singh H, Verma A, Ray V. Evaluation of fresh frozen plasma usage at a tertiary care hospital in North India. ANZ J Surg. 2005;75:573-6.

Makroo RN, Raina V, Kumar P, Thakur UK. A prospective audit of transfusion requests in a tertiary care hospital for the use of fresh frozen plasma. Asian J Transfus Sci. 2007;1:59-61.

Eagleton H, Benjamin S, Murphy MF. Audits of appropriate use of FFP. Blood Matters 2000;4:5-8.

Pahuja S, Sethi N, Singh S, Sharma S, Jain M, Kushwaha S, et al. Concurrent audit of fresh frozen plasma: Experience of a tertiary care hospital. Hematol. 2012;17:306-10.

Jayanthi N, Pitchai R. Audit of fresh frozen plasma usage and study the effect of fresh frozen plasma on the pre transfusion and post – Transfusion international normalized ratio. Int J Curr Med Appl Sci. 2015;7:34-9.

Patel V, Gajjar M, Bhatnagar N, Shah M, Shah M, Lahre S. An audit of plasma usage in tertiary care hospital. Int J Biomed Adv Res. 2015;6:331-3.

Shah SN, Sidhu M, Gupta V. Audit of fresh frozen plasma usage, prospective study: a report from department of immunohematology and transfusion medicine, government medical college Jammu, Jammu and Kashmir, India. Int J Res Med Sci. 2020;8:1371-4.

Lingegowda JB, Jeyakumar JD, Muddegowda PH, Pitchai R, Gopal N, Sinha P, et al. An audit of requests for fresh frozen plasma in a tertiary care center in South India. J Lab Physicians. 2016;8:41-4.

Agarwal N, Subramanian A, Pandey RM, Albert V, Karjee S, Arya V. An audit of fresh frozen plasma usage in a tertiary trauma care centre in North India. Indian J Hematol Blood Transfus. 2014;30:328-32.

Puri V, Dhal I, Singh K, Sharma G, Rai P, Sharma S. Critical audit of fresh frozen plasma transfusion practices in obstetric and gynecology departments in a tertiary care hospital – Where and what needs to be improved?. Glob J Transfus Med. 2019;4:175-9.