Labile Blood Products in 2016

Abstract

In France, labile blood products (LBP) are obtained from volunteer donors, donated as whole blood and/or through apheresis. Guidelines concerning their therapeutic use have been recently updated by ANSM and HAS (French Health Autorities). They define good practices and ensure the safety of both donors and recipients. The risk for transmissible disease is controlled through medical selection of donors, deleukocytation mandatory for all LBP, viral screening techniques and by viral attenuation for plasma. Transformations and/or qualifications can be applied to LBP to meet specific indications. Complications related to transfusion (immunological, allergic, infectious, overload) cannot be neglected and justify a reasoned prescription. The new technologies available are dominated by the use of lyophilized plasma in the emergency setting and also used for overseas military operations. In case of massive bleeding, the earliest possible association of plasma and platelets to the emergency transfusion of packed red blood cells (PRBC) halves the mortality due to exsanguination. The transfusion of whole blood, controlled and regulated, already commonly used in the war setting for logistic reasons, is now extrapolated to the civilian setting (during civil disasters equivalent to military situations). In the future may appear, among others, the expansion of virus-mitigation techniques to the PRBC and the opening of the lyophilized plasma market.