Liquid Plasma

OK, hang with me for a minute, because this is a little confusing. “Liquid Plasma” is a never-frozen plasma product separated from whole blood at any time from collection up to 5 days after the whole blood unit expires. Note that the product may only be transfused up to the same date: 5 days after the whole blood expiration date. Since whole blood is typically collected in CPD or CP2D anticoagulant/preservative solution with a 21 day shelf life in the U.S., Liquid Plasma typically has a maximum shelf life of 26 days and is stored refrigerated at 1-6C. Though the quantity of certain coagulation factors (especially Factor V and Factor VIII) decline substantially in a plasma product stored for this length of time, sufficient quantities remain to be at least somewhat useful as a starting point in urgent situations, especially trauma transfusion.

Think of Liquid Plasma as a “bridge product.” It’s obviously not as good as freshly thawed FFP or PF24 in trauma transfusion, but it serves as a bridge between the time the trauma patient starts being transfused and when that freshly thawed plasma product is available. I think the best use of this product is in hospitals that care for trauma patients, but not all that often (like once a week or so). Remember, “Thawed Plasma” only has a 5-day shelf life, so a trauma center may prefer to use Liquid Plasma, since Thawed Plasma units may expire on the shelf between trauma events.

Liquid Plasma does not need to be thawed (obviously) prior to transfusion, so it can be quite useful in situations where plasma is needed urgently. Per the Circular of Information, it is “indicated for the initial treatment of patients who are undergoing massive transfusion because of life-threatening trauma/hemorrhages and who have clinically significant coagulation deficiencies.” (Circular of Information for the Use of Human Blood and Blood Components, 2024, page 22).

One curious note: Since Liquid Plasma is never frozen, it contains viable white blood cells, so the T-lymphocytes in the unit have potential to cause transfusion-associated graft vs host disease if the recipient is at-risk for that complication. Theoretically, Liquid Plasma may be irradiated to prevent that complication, but most centers choose not to do so.

Updated December 2024 by Joe Chaffin MD

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