Effect of FFP Transfusion on International Normalized Ratio in Liver Disease Patients.

Fresh frozen plasma (FFP) is widely used in liver diseases to rectify coagulation derangements. In this study we have analysed the pattern of FFP usage in liver diseases and its effect on International normalized ratio (INR). A retrospective study of liver disease patients who received FFP transfusions from January 2016 to June 2016 was done. FFP used for liver transplant surgeries and plasma exchange procedures were excluded from the study. A total of 1935 units of FFP were transfused to 576 patients. We found a high linear correlation between pre transfusion INR and change in INR per unit of FFP. Patients receiving 6 units or more FFP have shown significant INR improvement. Improvement was more in acute liver failure and acute on chronic liver failure cases compared to chronic liver disease. FFP is not effective in correcting mild to moderate coagulation defects in liver diseases. Large volumes are required to cause significant INR improvement. Considering the risks associated with FFP transfusion, decision of transfusion should be carefully weighed. Future prospective randomized control trails are required for understanding the risk benefit ratio better and formulating plasma transfusion guidelines in liver diseases.