Factors affecting the quality of cryoprecipitate

Abstract

BACKGROUND:Many variables affect the quality of cryoprecipitate (CRYO). We investigated the effect of freezing techniques and ABO blood groups on the quality of CRYO with respect to factor VIII: C and fibrinogen levels.MATERIALS AND METHODS:Ninety-six whole blood units each collected from in-house (Group I) and blood donation camps outside the hospital premises (Group II) were processed for CRYO preparation. Within each group, half the number of plasma units was frozen using blast freezer and another half using the conventional freezer. The CRYOs from blood groups A, B, and O were equally distributed, i.e. 32 within each of the Groups I and II. The fibrinogen and factor VIII: C levels in CRYO were analyzed using single-stage clotting assay.RESULTS:In Group I, the mean ± standard deviation percentage recovery of factor VIII levels in CRYO prepared using the conventional freezer and blast freezer were 58.5% ±16.2% and 66.7% ±16.4%, respectively, and in Group II, it was 55.3% ±17.6% and 70.4% ±13.4%, respectively. Recovery of factor VIII was higher in CRYO prepared using blast freezer than that of CRYO prepared using conventional freezer (P < 0.000). In Group II, CRYOs prepared using blast freezer had higher percent recovery of fibrinogen than that of Group I. In both the groups, the mean factor VIII levels in blood group A were higher than that of factor VIII levels in the blood group O CRYO.CONCLUSION:The factor VIII recovery in CRYO improves significantly with higher baseline factor VIII: C levels, blood group A donor, and rapid freezing using blast freezer. Rapid freezing also increases the fibrinogen yield.

Pro-Con Debate: Fibrinogen Concentrate or Cryoprecipitate for Treatment of Acquired Hypofibrinogenemia in Cardiac Surgical Patients

“…15 Cryoprecipitate content is also affected by donor variability in factor activity and the type of freezer that is used for storage. 16 Most single donor cryoprecipitate units contain at least 250 mg of fibrinogen, which translates to 1.25 g of fibrinogen for a 5 donor pool or 1.5 g of fibrinogen for a 6 donor pool. 17 According to the American Red Cross, the mean factor VIII activity of a single donor cryoprecipitate unit is 136 IU and of a pool is 555 IU.…”

Mitigating the cryoprecipitate shortage by using apheresis plasma as a manufacturing source

“…In response: Thrombelastographic data in short-term cold storage of whole blood Dear Editor, We read Kusudo et al's in vitro examination of the short-term effects of whole blood (WB) storage at room or cold temperature 1 with interest, which adds to the evaluation of WB as it is increasingly used in clinical scenarios. 2 However, their selection and reporting of thrombelastography parameters with the thermoelectric generator (TEG) R 6 s device (Haemonetics Inc., Braintree, MA) is puzzling. In addition, the presentation of TEG data as a percentage of baseline does not allow for the…”

“…We did note the already known ABO blood group-related differences in the yields of fibrinogen and factor VIII. 2,3 This pilot study demonstrated that the volume of plasma within the parent bag was the single most important aspect influencing the yield of fibrinogen and factor VIII. The option of making CRYO from apheresis-derived plasma gives donor centers the ability to use the Apheresis plasma collected concurrently with platelets, schedule more plasma-only apheresis collections, and use donor pool of COVID-19 Convalescence Plasma (CCP) for making CRYO.…”