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Plasma Protein (Fractionation) Products

  • Pretransfusion testing is NOT required for plasma protein products.
  • All sizes and concentrations of plasma protein products may not available at all times.
  • Specialized plasma protein products may require Special Access Program (SAP) release through Health Canada and Canadian Blood Services. SAP release is determined by CBS and may vary upon product availability.  Contact Transfusion Medicine for direction.

Ordering Plasma Protein Products

Plasma protein products may be ordered in the following ways:

  • Hospital Information System.
  • Complete and forward to Transfusion Medicine the Hemophilia Factor Concentrates Order Form (CHR101120). 
  • Complete and forward to Transfusion Medicine a Blood Component/Product Requisition (REQ9006  adult or REQ9002 ACH neonatal/pediatric) for selected products requested at ACH, SCHC, SMCHC, Tom Baker Cancer Centre, and patient care units without a Hospital Information System. 

 The following information is required in order to process the request:

  • Patient legal last and first name
  • Patient Personal Health Number (PHN) or Medical Record Number
  • Patient location
  • Type of product
  • Quantity or volume required (coagulation factor concentrates require a dose)
  • Requesting physician
  • Priority of the request (stat, ASAP, routine, etc.)
  • Date and time the product is required
  • Body weight - pediatric patients only

For selected plasma protein products, Transfusion Medicine may request the completion of additional forms in order to process the request.

All requests for IVIG for patients who have not previously received IVIG and for those whose prior approval has elapsed, must have an Immune Globulin Initiation Form (TM2038) completed. The following information is required:

  • Patient demographic information    
    • Patient legal last and first name
    • Date of birth
    • Patient Personal Health Number (PHN)
    • Gender
  • Requesting/transfusing site and patient care unit and phone number
  • Ordering information
    • Date requested
    • Requesting physician
    • Physician's specialty
    • Requesting physician's phone or pager number
    • Patient height and weight
    • Clinical category and Indication
    • Dosing weight and use of Dose calculator
    • Induction dose (if applicable)
    • Maintenance dose, including duration
    • Scheduled date(s) of infusion
    • As applicable: IgG level, platelet count, other test results relevant to patient condition         

Incomplete or incorrect information may result in delay in blood product provision.