Cryoprecipitate
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Background
Cryoprecipitate (often shortened to "cryo") is made by thawing fresh frozen plasma (FFP) at 4° C, centrifuging the plasma, and collecting the white precipitate. The precipitate is dissolved back into a small sample of FFP and frozen again.
This more concentrated solution is rich in von Willebrand factor, factor VIII, factor XIII, and fibrinogen.
Cryoprecipitate is typically dose in pooled units; usually 5 units of cryoprecipitate are given at a time. Since cryo is stored in a frozen state it must be thawed prior to being dispensed by the blood bank. There is typically a 30 minute delay between ordering the product and when it can be administered.
The bodies response to 10 units of cryoprecipitate typically is an increase in fibrinogen of approximately 70 mg/dl.
Contraindications
As with any allogenic blood product patient refusal is an absolute contraindication to transfusion. If a patient refuses transfusion of blood products for religious or any other reason a discussion should be had prior to any procedure to discuss what products they will or will not accept.
Absolute contraindications
Precautions
ABO compatibility is recommended even though there is no packed red blood cells in the solution to avoid transfer of ABO antibodies that may be present in the residual plasma. This is especially important in more susceptible populations such as neonates and transplant recipients.
Rh compatibility is, however, not necessary as most red blood cells are removed in the centrifuge and freeze/thaw cycles used to concentrate the cryoprecipitate.