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What is Cryoprecipitate (Fibrinogen)?

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asked Apr 23, 2012 in Glossary by LarryEitel (1,360 points)

1 Answer

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Cryoprecipitate (Fibrinogen) is a protein present in blood plasma which is the cold insoluble portion of plasma that remains after the plasma has been thawed at 1-6 degrees centigrade. This material contains factor VIII, fibrinogen, fibronectin, and factor XIII, and produces fibrin which is responsible for clotting of the blood.

There are several studies that report that the infusion of cryoprecipitate has corrected the bleeding time and ameliorated bleeding. The "cryos" have also been successfully used in correcting Disseminated Intravascular Coagulopathy (DIC), a condition that presents with altered blood coagulation usually associated with complicated childbirth or lengthy surgery. DIC always is the end result of a serious underlying disorder and a life-threatening situation.

The major aim of replacement therapy with blood products in (DIC) is to replace fibrinogen. This goal is best accomplished by the administration of cryoprecipitate, each unit of which contains approximately 200 mg of fibrinogen. The amount of cryoprecipitate given should be sufficient to elevate the plasma fibrinogen level to at least 150 mg/dl.

The cryoprecipitates undergo subsequent purification by chemical or other treatment processes. Despite the purification procedures which include alcohol precipitation, wet heat-treated, dry heat-treated, and solvent/detergent processes, some viruses have been identified. --Wintrobe’s Clinical Hematology tenth edition, Volume 2 pages 1651-1659.

Cryoprecipitated antihemophilic factor (factor VIII) is a concentrate prepared from FFP. Each concentrate usually contains factor XIII, about 80 U. of factor VIII and factor VIII:VWF plus about 250 mg of fibrinogen. Although originally used for hemophilia, von Willebrand’s disease, and DIC, it is currently used as a source of fibrinogen in cardiothoracic-surgery ("fibrin glue") and obstetric emergencies. In general, it should not be used for other indications, (Preferred therapy for hemophilia and vonWillebrand’s disease now includes recombinant or viral inactivated factor concentrates or desmopressin acetate (DDAVP.) --The Merck Manual Seventeenth Edition 1999.

In addition to significant levels of fibrinogen and factor VIII, cryoprecipitate contains vWf and fibronectin. For fibrinogen deficiencies, cryoprecipitate is preferable over the commercial fibrinogen preparation because of the lesser incidence of hepatitis. Currently, commercially prepared factor VIII preparations are used more often than the cryoprecipitate prepared from FFP for the treatment of hemophilia. The recent development of factor VIII with recombinant DNA techniques has practically eliminated the transmission of hepatitis¹. Before administration, the cryoprecipitate must be thawed in a 37 degree C water bath and aseptically pooled into one dose. The thawed product should be stored at room temperature and administered rapidly through a filter. The infusion should be completed within 6 hours of thawing². --Blood Conservation in the Surgical Patient M.Ramez Salem 1996

Consult your physician for additional information. The use of this product is a matter of conscience for some.

¹ White GC. II, McMillan CW, Kindon HS, et al. Use of recombinant antihemophilic factor in the treatment of two patients with classic hemophilia N.Engl J Med 1989 320:166
² Walker RH Technical Manual 10th ed. Arlington, Va: American Association of Blood Banks 1990

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answered Apr 23, 2012 by LarryEitel (1,360 points)