To the Editor,During a repeat single-lung transplant, severe coagulopathy with hemorrhage developed in a patient who then went on to require massive transfusion of blood and blood products. Three units of fresh frozen plasma (FFP) that were sent from the blood bank had strikingly different colours (Figure). We queried anesthesiology and surgical team members in the operating room, and all were unaware of the etiology and therefore the suitability to transfuse one of these units (Bag No. 3: green discolouration). Subsequently, this bag was returned to the blood bank. On follow-up, we realized that it was safe to administer this green discoloured unit of FFP to patients. We not only identified a knowledge gap in health care providers routinely dealing with blood and blood product transfusion, -but also recognized that valuable blood bank and operating room resources were diverted to deal with the issue. It is essential that anesthesiologists recognize normal and abnormal variations in the appearance of FFP. Accordingly, we present a brief review of the wide-ranging appearances of FFP encountered in daily practice.
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