Blood Component: Cryoprecipitate is a blood product prepared from fresh frozen plasma (FFP). It is the cold-insoluble fraction that precipitates when FFP is thawed at a controlled temperature (1∘C to 6∘C).
Composition: It is rich in several key coagulation factors, including Factor VIII, von Willebrand factor (VWF), fibrinogen, Factor XIII, and fibronectin.
Concentrated Form: Each unit of cryoprecipitate is a concentrated source of these factors, typically containing at least 150 mg of fibrinogen and 80 IU of Factor VIII.
Storage and Thawing: Like FFP, cryoprecipitate is stored in a frozen state. It must be thawed just prior to transfusion and is available as a small volume product.
Advantages
High Concentration of Key Factors: Provides a potent, small-volume source of fibrinogen, Factor VIII, and VWF, making it ideal for correcting deficiencies of these specific factors without excessive fluid volume.
Rapid Action: Transfusion provides immediate replacement of the target coagulation factors, which can quickly control bleeding in an emergency.
Versatile Use: It is a valuable tool for treating a range of bleeding disorders, especially those involving deficiencies of fibrinogen or VWF, where specific concentrates may not be available.
Readily Available: As a standard component prepared from whole blood donations, it is a readily available product in most blood banks.
Uses
Treatment of Fibrinogen Deficiency: The primary and most common indication is for the treatment of bleeding in patients with congenital or acquired fibrinogen deficiency, such as in Disseminated Intravascular Coagulation (DIC), liver disease, or massive hemorrhage.
Von Willebrand Disease: Used to treat bleeding episodes or for surgical prophylaxis in patients with certain types of von Willebrand disease, particularly when VWF concentrate is not available or is not effective.
Hemophilia A: Can be used as a source of Factor VIII for the treatment of Hemophilia A when specific Factor VIII concentrates are not available.
Factor XIII Deficiency: Indicated for the management of bleeding in patients with congenital Factor XIII deficiency.
Nature
Source Material: Cryoprecipitate is prepared by thawing fresh frozen plasma, collecting the precipitate, and then refreezing it. This process concentrates several of the most critical clotting factors.
Mechanism of Action: The therapeutic effect is to provide a high concentration of key coagulation factors that are deficient in the patient. By providing fibrinogen and Factor XIII, it improves the stability of the blood clot. By providing Factor VIII and VWF, it helps to initiate and propagate the clotting cascade.
Non-Sterile Product: As it is a pooled blood product, it cannot be considered sterile. It carries a small risk of transmitting infectious diseases, though this risk is significantly reduced by modern donor screening and testing.
Requires ABO Compatibility: While not as critical as for red cells, ABO compatibility is generally recommended for cryoprecipitate transfusions to minimize the risk of a transfusion reaction from the small amount of residual antibodies.
Storage
Frozen State: Cryoprecipitate must be stored frozen at a temperature of −18∘C or colder to preserve the activity of its coagulation factors.
Shelf Life: In its frozen state, it has a shelf life of up to one year from the date of collection.
Thawing Process: It must be thawed in a controlled manner (e.g., in a 37∘C water bath) immediately before use.
Post-Thaw Shelf Life: Once thawed, cryoprecipitate is only stable for a limited time (typically up to 6 hours) at room temperature. It should not be re-frozen, and any unused portion must be discarded.
