This RAP session will generate discussion on an optimal approach for warfarin reversal in clinical practice. In the US, FFP transfusion is still considered as a standard therapy for urgent warfarin reversal despite numerous disadvantages as compared to the Prothrombin Complex Concentrate (PCC), which has been routinely used in Europe for warfarin reversal for decades. There are two types of PCCs – activated (aPCC; e.g FEIBA) which is used for treating hemophiliacs with inhibitors and non-activated PCC (PCC) – that were used to treat hemophilia B (FIX) in the past. The PCCs available in the US are called “3-factor PCC” since they are known to contain a significantly lower quantity of FVII in comparison to 4-factor PCC available in Europe and Canada that contain balanced quantities of all vitamin K dependent factors including protein C and S. There is significant delay in warfarin reversal with FPP because the ABO type has to be determined, FFP needs to thawed, and the transfusion in elderly patients with multiple medical problems including poor cardiac status has to be very slow. There is also serious risk of transfusion associated circulatory overload in elderly patients. The main concern for PCC use is potential thrombotic complications. Thus, this session should generate lively, interactive discussion between opponents and proponents of FFP.