John Libbey Eurotext



Indications for different types of plasma in hematological diseases Volume 15, issue 5, septembre-octobre 2009

Établissement français du sang Lorraine-Champagne, Vandœuvre-les-Nancy, Service d’hématologie, CHU Nancy, Inserm U684, Vandœuvre-les-Nancy, Nancy-Université

The clinical uses of fresh frozen plasma (FFP) are supervised by rules and national guidelines in haematology. The first indication of FFP is the thrombotic thrombocytopenic purpura. In 2008, the Ministry of Health has decided of the use of pathogen-reduced plasmas. Two are mainly transfused: solvant/detergent-treated plasma (PVA-SD) and methylene blue-light treated plasma (PVA-BM). One is in experimental site: amotosalen-ultraviolet light treated plasma (PVA-IA). These plasmas have a variable action against viruses according to their process mode. PVA-SD is issued from a pool of 100 donors, PVA-BM and PVA-IA are prepared from single plasma donation. The process of pathogen-reduction have for consequence a more or less important degradation of some factors of haemostasis but each pathogen-reduced plasma respects the hemostatics characteristics of plasma as demonstrated by the global tests of haemostasis. The implementation of PVA-BM was associated with a number of declarations of reactions labelled “allergy” more important than with FFP and PVA-SD. Explorations are in progress to know the exact origin. The guidelines of clinical use of pathogen-reduced plasmas are the same that those of FFP. PVA-BM can not be used in case of sensitization to the methylene blue. Differents pathogen-reduced plasmas can be used indifferently in the indications of hematological diseases.