Name: Cryoprecipitate

Cryoprecipitated AHF (Cryoprecipitate)

Cryoprecipitated AHF, Pooled

Description/Contents: The cold insoluble portion of plasma that precipitates when fresh frozen plasma is thawed at 1-6 ^oC. The supernatant (cryo-poor plasma) is removed and the residual volume of cryoprecipitate (approximately 15 ml) is refrozen and stored at -18 ^oC. Cryoprecipitate provides therapeutic amounts of Factor VIII:C, Factor XIII, von Willebrand factor, and fibrinogen. Each bag of cryoprecipitate contains 80-100 units of Factor VIII:C and 150-200 mg of fibrinogen (Factor I). In addition, significant amounts of Factor XIII (fibrin-stabilizing factor) and von Willebrand factor (vWF), including the high molecular weight multimers of vWF, are also present.

• Treatment of bleeding due to hypofibrinogenemia or dysfibrinogenemia.

• Cases of disseminated intravascular coagulation where both fibrinogen and Factor VIII may be depleted.

• Prophylaxis or treatment of significant Factor XIII deficiency.
  

Historically, patients with von Willebrand's disease (vWD) and Hemophilia A have been treated with Cryoprecipitate. Safer products are now available (See Alternative Therapy). Cryoprecipitate should not be used in the treatment of Hemophilia B (Factor IX deficiency, Christmas disease).

Cryoprecipitate has also been used in the production of "fibrin glue" with the addition of thrombin to form an insoluble clot for application to surgical margins and other surgical applications. Such use is not FDA-approved, although widespread. The safety of this procedure, including the risk of the thrombin source, has not been established.

Dosage and Administration: For fibrinogen replacement, ten bags of cryoprecipitate will increase the fibrinogen level of a 70 kilogram recipient approximately 70 mg/dl. Cryoprecipitate is administered after pooling. Compatibility testing is not necessary, but the product should be ABO plasma compatible. Rh type is not important.

Alternative Therapy: Factor VIII concentrates that are made with recombinant DNA technology or have been pasteurized are safer and are the treatment of choice for patients with hemophilia A and von Willebrand's disease. DDAVP (desmopressin) causes the release of Factor VIII and vWF in most patients with mild-moderate Hemophilia A and vWD. Therefore, DDAVP may be used instead of cryoprecipitate or factor concentrates in these patients. Consult the Blood Bank/Transfusion Medicine physician or Hematologist in such cases.

References:

Pool JG, Shannon AE. Production of high potency concentrates of antihemophilic globulin in a closed bag system; assay in vitro and in vivo. N Engl J Med 1965;273:1443-1447.

Task Force of the College of American Pathologists. Practice parameters for the use of FFP, cryoprecipitate, and platelets. JAMA 1994;271:777-781.

Transfusion Guidelines

Plasma Guidelines	Antithrombin III Guidelines
Platelet Guidelines	Activated Protein Guidelines
Red Cell Guidelines	Factor IX Guidelines
Cryoprecipitate Guidelines	Factor VIII Guidelines
AICC/Porcine Factor VIII Guidelines	IVIG Guidelines Coagulation Factor VII Guidelines

Back To Professionals Home Page