Cryoprecipitate is made from thawing FFP and collecting a precipitate rich in fibrinogen, factor VIII and von Willebrand factor
- developed initially for treatment of haemophilia patients, now mainly used as a more concentrated, hence lower volume for infusion, source of fibrinogen than FFP.
Available from the Blood Services as single-donor packs or as pools of five donations
- recommended adult therapeutic dose - two pools of five units (or one unit per 5–10 kg body weight),
- this will typically raise the plasma fibrinogen by about 1 g/L (1).
Indications for transfusion of cryoprecipitate:
- haemorrhage after cardiac surgery
- massive haemorrhage or transfusion
- surgical bleeding
- as an alternate to factor VIII concentrate in the treatment of inherited deficiencies of:
- von Willebrand Factor (von Willebrand’s disease)
- factor VIII (haemophilia A)
- factor XIII (2,3)
- as a source of fibrinogen in acquired coagulopathies: e.g. disseminated intravascular coagulation (DIC)
If possible, use ABO-compatible product. Compatibility testing not required (3)
NICE guidelines recommendations on cryoprecipitate transfusion include:
- consider cryoprecipitate transfusions for patients without major haemorrhage who have:
- clinically significant bleeding and
- a fibrinogen level below 1.5 g/litre
- do not offer cryoprecipitate transfusions to correct the fibrinogen level in patients who:
- are not bleeding and
- are not having invasive procedures or surgery with a risk of clinically significant bleeding
- consider prophylactic cryoprecipitate transfusions for patients with a fibrinogen level below 1.0 g/litre who are having invasive procedures or surgery with a risk of clinically significant bleeding.
- use an adult dose of 2 pools when giving cryoprecipitate transfusions (for children, use 5–10 ml/kg up to a maximum of 2 pools).
- reassess the patient's clinical condition, repeat the fibrinogen level measurement and give further doses if needed (4)
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