British Society of Haematology Guidelines on the spectrum of fresh frozen plasma and cryoprecipitate products: their handling and use in various patient groups in the absence of major bleeding (Br J Haematol. 2018;181:54–67). Addendum August 2020
Following publication of the British Society of Haematology (BSH) guideline on the spectrum of fresh frozen plasma (FFP) and cryoprecipitate products,1 there have been a number of changes requiring this addendum, prior to revision of the guideline as a whole.
Implications of the Advisory Committee for the Safety of Blood, Tissues and Organs (SaBTO) 2019 advice to cease recommending imported plasma and apheresis platelets for individuals born on or after 1 January 1996 or with thrombotic thrombocytopenia (TTP)
The requirement to import plasma for treatment of individuals born on or after 1 January 1996 or with TTP was introduced in 2004 in the UK, as part of variant Creuzfeldt–Jacob disease (vCJD) risk reduction measures. In September 2019, the Department of Health and Social Care withdrew this requirement and approved the use of UK-sourced plasma and pooled platelets for these individuals (https://www.parliament.uk/business/publications/written-questions-answers-statements/written-statement/Commons/2019-09-09/HCWS1821/), following the publication of advice and a comprehensive assessment of the vCJD risk by SaBTO (https://www.gov.uk/government/publications/risk-reduction-measures-for-variant-creutzfeldt-jakob-disease-pcwg-report). For details on the use of plasma for treatment of patients with TTP, also refer to the relevant BSH guideline.2
The Joint UK Blood Transfusion and Tissue Services Professional Advisory Committee (JPAC) subsequently agreed that UK plasma for those born on or after 1 January 1996 does not need to be pathogen inactivated, similar to UK plasma for all other age groups (October 2019, https://www.transfusionguidelines.org/about/minutes-of-jpac-meetings).
Plasma components for neonates, infants and older children
Imported methylene blue (MB)-treated FFP and MB cryoprecipitate will no longer be available from UK Blood Services once the currently available stock has been used; they will be replaced by UK plasma components.
Note: neonatal/infant FFP has a maximum 24-h shelf-life post thawing when stored at 4 ± 2°C (in contrast to standard FFP which may be used up to 120 h post thawing at 4 ± 2°C for recipients with unexpected major haemorrhage).
For children from 1 year of age, FFP and cryoprecipitate will be the standard UK ‘adult’ component. HT-negative ‘adult’ FFP is available, but not all components are routinely tested. Apart from the change in plasma component specifications, other information on plasma transfusion in the guidelines is unchanged.
