Cryoprecipitate, also called cryo for short, is a frozen blood product prepared from blood plasma.[1] To create cryoprecipitate, fresh frozen plasma thawed at 1–6 °C, is then centrifuged and the precipitate is collected. The precipitate is resuspended in a small amount of residual plasma (generally 10–15 mL) and is then re-frozen for storage. It is often transfused to adults as two 5-unit pools instead of as a single product. One of the most important constituents is factor VIII (also called antihaemophilic factor or AHF), which is why cryoprecipitate is sometimes called cryoprecipitated antihaemophilic factor or cryoprecipitated AHF. In many clinical contexts, use of whole cryoprecipitate has been replaced with use of clotting factor concentrates made therefrom (where available), but the whole form is still routinely stocked by many, if not most, hospital blood banks. Cryo can be stored at −18 °C or colder for 12 months from the original collection date.[2] After thawing, single units of cryo (or units pooled using a sterile method) can be stored at 20–24 °C for up to 6 hours. If units of cryo are pooled in an open system, they can only be held at 20–24 °C for up to 4 hours.[2] Presently cryo cannot be re-frozen for storage after it is thawed for use if it is not transfused.

Cryoprecipitate
Clinical data
Other namesCryo, cryoprecipitated antihaemophilic factor, cryoprecipitated AHF
Identifiers
ChemSpider
  • none

Cross-matching (compatibility testing) is not necessary and all ABO groups are acceptable for transfusion to people of all ABO types.[1]

Medical usesEdit

Medical uses for giving cryoprecipitate include:[3]

Adverse effectsEdit

Adverse effects reported with the usage of cryoprecipitate include hemolytic transfusion reactions, febrile non-hemolytic reactions, allergic reactions (ranging from urticaria to anaphylaxis), septic reactions, transfusion related acute lung injury, circulatory overload, transfusion-associated graft-versus-host disease, and post-transfusion purpura.[4]

CompositionEdit

Each unit (around 10 to 15 mL) typically provides:[5]

Cryoprecipitate also contains fibronectin; however there are no clear indications for fibronectin replacement.

US standards require manufacturers to test at least four units each month, and the products must have a minimum of 150 mg or more of fibrinogen and 80 IU of factor VIII.[2][6] Individual products may actually have less than these amounts as long as the average remains above these minimums. Typical values for a unit are substantially higher, and aside from infants it is rare to transfuse just one unit.

HistoryEdit

While the method for the creation of Cryo was discovered by Dr. Judith Graham Pool from Stanford University in 1964,[7] it was initially approved in 1971 by the U.S. Food and Drug Administration under the name Cryoprecipitated AHF for the Hoxworth Blood Center University of Cincinnati Medical Center.[8]

ReferencesEdit

  1. ^ a b Technical manual. Fung, Mark K., Grossman, Brenda J., Hillyer, Christopher D., Westhoff, Connie M., American Association of Blood Banks. (18th ed.). Bethesda, Md.: American Association of Blood Banks. 2014. ISBN 978-1563958885. OCLC 881812415.CS1 maint: others (link)
  2. ^ a b c Committee., American Association of Blood Banks. Standards Program (2018). Standards for blood banks and transfusion services (31st ed.). Bethesda, Maryland. ISBN 978-1563959585. OCLC 1022963387.
  3. ^ Erber WN, Perry DJ (2006). "Plasma and plasma products in the treatment of massive haemorrhage". Best Pract Res Clin Haematol. 19 (1): 97–112. doi:10.1016/j.beha.2005.01.026. PMID 16377544.
  4. ^ "CRYO (cryoprecipitate) Adverse Effects". Medscape.
  5. ^ "CRYO (cryoprecipitate) pharmacology". Medscape.
  6. ^ "Circular of Information For the Use of Human Blood and Blood Components" (PDF). Archived from the original (PDF) on 2008-02-27. Retrieved 2008-02-28.
  7. ^ Pool, Judith G.; Hershgold, Edwabd J.; Pappenhagen, Albert R. (July 1964). "High-potency Antihæmophilic Factor Concentrate prepared from Cryoglobulin Precipitate". Nature. 203 (4942): 312. doi:10.1038/203312a0. ISSN 0028-0836. PMID 14201780.
  8. ^ "Alphabetical List of Licensed Establishments Including Product Approval Dates as of 30-APR-2019". FDA.