Transfusion therapy in acquired coagulopathies.

Acquired coagulopathies, such as are observed in patients with liver disease, uremia, and acute disseminated intravascular coagulation, are complex disorders usually involving a combination of deficiency of multiple coagulation factors, platelet dysfunction, and thrombocytopenia. Transfusion of specific blood products, such as fresh-frozen plasma, platelets, and cryoprecipitate, may be effective in the treatment and prevention of hemorrhage in patients with these disorders; however, the optimal regimens continue to be defined. Because the risks of virus transmission along with hemolytic and allergic reactions continue to accompany blood product transfusions, nontransfusional forms of treatment of acquired coagulopathies, such as desmopressin acetate, antifibrinolytic agents, and aprotinin, have assumed greater roles in the treatment of these hemostatic disorders. Much work remains to define better the most effective and safest approach to the treatment of the acquired coagulopathies.