Over the past decade hospitals throughout the United States have experienced a dramatic increase in utilization of freshfrozen plasma (FFP). Since this has paralleled a corresponding increase in transfusion of packed red blood cells in relation to whole blood, it may be inferred that much of the FFP is being transfused as a volume expander, rather than as a source of clotting factors or plasma proteins. Use of plasma in this manner not only increases the cost of transfusion, but also increases the risk of transfusion-transmitted disease. Therefore, the recent Consensus Development Conference on this subject, convened by the National Institutes of Health and reported in this issue of The Journal,1 was both timely and appropriate.
The conference concluded that there was "little scientific evidence to support the increasing use of FFP," especially as a volume expander, as there are safer products that will achieve the same effect. While