Risks
The risks of FFP include disease transmission, anaphylactoid reactions, alloimmunization, and excessive intravascular volume, as well as transfusion related acute lung injury (TRALI) and an increase in infections (including surgical wound infections). The potential viral infectivity of FFP probably is similar to that of whole blood and red blood cells. The rate of posttransfusion hepatitis depends on many factors, including donor selection. In rare instances, human immunodeficiency virus (HIV) is transmitted by blood transfusions and possibly by FFP. Allergic or anaphylactoid reactions can occur in response to FFP administration and may vary from hives to fatal noncardiogenic pulmonary edema.
FFP should be blood type-matched to ensure compatibility, as agglutination reactions are possible, though rare. The potential for alloimmunization is present, as demonstrated by the infrequent formation of anti-Rh antibodies. For this reason, plasma containing anti-D antibodies (from an RhD-negative donor) is preferably not given to an RhD-positive recipient, and RhD-positive plasma is avoided in RhD-negative women of child-bearing age. As with any intravenously administered fluid, excessive amounts of FFP may result in hypervolemia and cardiac failure.
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