J.Jpn. Surg. Soc.. 87(9): 952-955, 1986

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Report on the annual meeting

APPROPRIATE USE OF BLOOD AND BLOOD PRODUCTS－GUIDELINES FOR IMPROVING PRACTICE

In Japan, the use of fresh frozen plasma (FFP) and albumin has increased dramatically over the past 10 years, and half the usage is in surgical conditions. Most reviews acknowledge that much of FFP or albumin is wasted, or used without a firm scientific basis. Moreover Japan has imported enormous volume of plasma as raw materials or various plasma derivatives from foreign countries, and has received much criticism ethically from all sides.
At first, more red blood cells concentrates should be used in order to move much more plasma for preparation of plasma derivatives. Whole blood transfusion is rarely indicated except in cases of activated massive bleeding and in exchanged transfusion.
It is concluded that appropriate uses of FFP are limited within replacement of coagulation deficiencies, and there is no justification for its administration as a volume expander or as a nutrition source. FFP includes transmission of diseases such as hepatitis and possibly AIDS.
Albumin is an effective oncotic agent in the treatment of acute shock, adult respiratory distress syndrome and in maintenance of intravascular volume and cardiac output. But albumin is of no demonstrable value in the general supportive management of the hypoproteinemia of liver cirrhosis, nephrotic syndrome or undernutrition.

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