cryoprecipitate

Last reviewed 01/2018

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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