CME-Cryoprecipitate.ppt22mar

1. Contents
●What is cryoprecipitate
●Production of cryoprecipitate
●Functions of cryoprecipitate
●Indications for cryoprecipitate

2. •A concentrate of cold and insoluble high-molecular-weight
plasma proteins.
•Precipitates when frozen plasma is slowly thawed at 1–6°C.
•Contains the following blood clotting proteins:
oFibrinogen
oFactor VIII
oFactor XIII
oVon Willebrand factor
What is cryoprecipitate

3. Production of cryoprecipitate
Centrifuge whole blood
Extract Plasma
Snap Freeze
Dry ice/alcohol
-60°C for 10 minutes
Attach satellite bag

4. Production of cryoprecipitate
Thaw until there is some precipitation
3°C for 20-30 minutes
Precipitated
component
Cryodepleted
Plasma
Cryoprecipitate
Store at -20°C
or lower

5. Functions of cryoprecipitate
●Fibrinogen
oFibrinogen is converted to fibrin, to form a stable blood clot at the
site of vascular disruption.
●Factor VIII
oAntihemophilic factor
oProtein deficient or absent in individuals with classic hemophilia,
an X-chromosome-linked bleeding disorder.
oParticipates in the intrinsic pathway of blood coagulation.

6. Functions of cryoprecipitate

7. Indications for Cryoprecipitate
●Hypofibrinogenemia*
○fibrinogen ≤100 mg/dL [1.00 g/L]
●TPA-related life-threatening hemorrhage*
●Massive transfusion*
○>10 RBC units in 24 h with continued bleeding
●Uremic bleeding*
Accepted Indications for the Use of Cryoprecipitate at Beth Israel Deaconess Medical Center, Boston, MA*

8. Indications for Cryoprecipitate
●von Willebrand disease
oUnresponsive to desmopressin(DDAVP)
●Hemophilia A
oF VIII:C concentrates are not available
●Factor XIII deficiency
oRare hereditary deficiency
oWhen plasma-derived F XIII concentrate (Fibrogammin P) is
not available in emergent situations.

9. References
Andersson, L. O., Forsman, N., Huang, K., Larsen, K., Lundin, A., Pavlu, B., . . . Sandberg, H.
(1986, May). Isolation and characterization of human factor VIII: Molecular forms in commercial
factor VIII concentrate, cryoprecipitate, and plasma. Proceedings of the National Academy of
Sciences of the United States of America, 83,2979-2983. Retrieved from
http://www.pnas.org/content/83/9/2979.full.pdf
Australian Red Cross Blood Service. (2014, August 22). What's in a bag of cryoprecipitate?
Retrieved March 17, 2015, from http://mytransfusion.com.au/node/whats-bag-cryoprecipitate
Australian Red Cross Blood Service. (2014, September 23). Use of cryoprecipitate. Retrieved
March 19, 2015, from
http://www.transfusion.com.au/blood_products/components/cryoprecipitate/use
Australian Red Cross Blood Service. (2015, August 22). What's in a bag of cryodepleted
plasma? Retrieved March 21, 2015, from http://www.mytransfusion.com.au/node/whats-bag-
cryodepleted-plasma
Bayer Pharma AG. (2015, March 14). The Coagulation Cascade. Retrieved from
http://www.thrombosisadviser.com/en/understanding-thrombosis/the-coagulation-cascade/
Blood Component Therapy. (2010). Retrieved March 15, 2015, from
http://perinatology.com/Reference/OBPharmacopoeia-Public/Blood%20component.htm

10. References
Droubatchevskaia, N., & Wong, M. P. (2007, October 8). Guidelines for cryoprecipitate
transfusion. BC Medical Journal, 49,441-445. Retrieved March 17, 2015, from
http://www.bcmj.org/article/guidelines-cryoprecipitate-transfusion
Encyclopaedia Britannica. (2015). Fibrinogen. Biochemistry.Retrieved March 18, 2015, from
http://global.britannica.com/EBchecked/topic/205888/fibrinogen
Federici, A. B. (2003, June). The factor VIII/von Willebrand factor complex: basic and clinical
issues. Haematologica, 88(6). Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12826528
Lloyd, S. (2004, June). The Preparation of Single Donor Cryoprecipitate. Retrieved from
http://www1.wfh.org/publication/files/pdf-1221.pdf
Queen's University. (n.d.). Cryoprecipitate[Photograph]. Retrieved from
https://meds.queensu.ca/central/assets/modules/clerk_bloodtrans_draft/cryoprecipitate.html
Pantanowitz, L., Kruskall, M. S., & Uhl, L. (2003). Cryoprecipitate. Patterns of Use. American
Journal of Clinical Pathology, 119, 874-881. Retrieved February 11, 2015, from
http://ajcp.ascpjournals.org/content/119/6/874.full.pdf

11. References
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Sparrow, R. L., Greening, D. W., & Simpson, R. J. (2011, February 23). A Protocol for the
Preparation of Cryoprecipitate and Cryodepleted Plasma. Methods in Molecular Biology, 728,
259-265. Retrieved March 3, 2015, from http://link.springer.com/protocol/10.1007/978-1-
61779-068-3_17#page-1
Szymanski, I. (n.d.). Clinical Use of Plasma for Transfusion. Retrieved March 16, 2015, from
http://www.fda.gov/ohrms/dockets/ac/05/slides/2005-4096S1_13.pdf
Transfusion Medicine For Registrars -WPBTS.Retrieved March 5, 2015, from
http://www.haematology.uct.ac.za/sites/default/files/image_tool/images/141/transfusion_medi
cine_for_registrars