Fresh Frozen Plasma Storage Guidelines

Initial Storage Requirements

Fresh frozen plasma must be stored frozen at -25°C or below, and once thawed can be stored at 4°C for up to 24 hours for general use, with an extended 5-day storage period specifically for major hemorrhage associated with trauma 1, 2
FFP is rapidly frozen to below -25°C to maintain the integrity of labile coagulation factors V and VIII 1, 2
This freezing process preserves all factors of the soluble coagulation system 2

FFP can be thawed using three acceptable methods: dry oven, microwave, and water bath 1, 2
Dry oven thawing takes 10 minutes 1
Microwave thawing takes 2-3 minutes 1
Water bath thawing takes 20 minutes at 37°C 1

Thawed FFP can be stored at 4°C for up to 24 hours 1, 2, 3
Once removed from refrigeration, FFP must be used within 30 minutes 1, 2
Never refreeze thawed FFP 1, 2
For major hemorrhage associated with trauma, storage time has been extended to 5 days at 4°C 1, 2

FFP should be ABO-compatible with the recipient 2, 3
If blood group is unknown, use group AB FFP as it contains no anti-A or anti-B antibodies 2, 3
For group O FFP given to non-group O children, it must be high-titre (HT) negative 2

Approximate volume per bag is 300 mL 1, 2
Recommended therapeutic dose is 15 mL/kg to achieve minimum 30% concentration of plasma factors 2, 3

Patient identification must be verified against the bag label before administration 1, 2
Every effort must be made to avoid wastage given specific storage constraints 1, 2
Male-only plasma is preferentially used in the UK to reduce transfusion-related acute lung injury (TRALI) risk 1, 2

Fresh frozen plasma (FFP) provides the full complement of soluble coagulation factors—including labile factors V and VIII at approximately 0.5–1.0 IU/mL each, fibrinogen (~2 g per four units), von Willebrand factor, protein C, protein S, antithrombin III, and α‑2‑antiplasmin—sufficient for hemostatic support in bleeding patients. 4
Four units of FFP deliver roughly 2 g of fibrinogen, which is about half the fibrinogen amount supplied by two pools of cryoprecipitate (~4 g). 4

Factors V and VIII are the most temperature‑sensitive components of FFP; rapid freezing to below ‑25 °C is essential to preserve their activity. 4
Each standard FFP bag holds approximately 250–300 mL of plasma. 4
FFP is produced as leucodepleted plasma that is rapidly frozen to temperatures below ‑25 °C to maintain factor integrity and reduce leukocyte‑related reactions. 4

In the United Kingdom, FFP has been sourced preferentially from male donors since 2003 to lower the risk of transfusion‑related acute lung injury (TRALI), because anti‑HNA and anti‑HLA antibodies are more prevalent in multiparous women. 4
ABO compatibility is required for FFP transfusion; when the recipient’s blood group is unknown, group AB plasma is preferred because it lacks anti‑A and anti‑B antibodies. 4